Impact of the COVID-19 pandemic on the trauma and orthopaedic department at level one Major Trauma Centre in the republic of Ireland

Abstract

The Coronavirus Disease (COVID-19) has been identified as the cause of a rapidly spreading respira- tory illness in Wuhan, Hubei Province, China in early December 2019. Since then, the free movement of people has decreased. The trauma-related injuries and the demand on the trauma and orthopaedic service would be expected to fall. The aim of this study to examine the impact of the COVID-19 pandemic on a level 1 Trauma Centre in the Republic of Ireland (ROI). Patients admitted to the Trauma & Orthopaedic (T&O) Department at Cork University Hospital (CUH) and the South Infirmary Victoria University Hospital (SIVUH), and their associated fracture patterns and management, between 01/03/20 and the 15/04/20 were documented and compared to the patient admissions from the same time period one year earlier in 2019. The total number of T&O operations performed decreased by 10.15% (P= 0.03)between the two time periods. The number of paediatric procedures fell by 40.32% (P= 0.15). Adult Distal radius and paediatric elbow fractures (excluding supracondylar fracture) increased by 88% and 13% (P= 0.19), (P= 0.04) respectively. Hip fractures remained the most common fracture-type admitted for surgery. The COVID-19 crisis has to lead to a decrease in the total numbers of trauma surgeries in a major trauma centre in the ROI. This decline is most evident in the number of paediatric and male adult patients presenting with fractures requiring operative management. Interestingly, fractures directly related to solo outdoor activities, such as running or cycling, as well as simple mechanical falls like ankle, distal radius, elbow, and hand fractures all increased. Irish males were more compliant with outdoors restrictions than females.

Changes in trends of orthopedic services due to the COVID-19 pandemic: A review

“…Hip replacements are generally the most common elective procedure, but elective procedures were halted and therefore most institutions did not perform them. Hip fractures have still been very common during this time[ 4 , 25 , 28 ]; however, the pandemic has increased the mortality and complication rate particularly amongst COVID-positive patients[ 5 , 8 , 11 , 16 , 38 ]. The importance of early treatment and proper rehabilitation was strongly emphasized in order to ensure prompt recovery[ 14 ].…”

“…COVID-19 impacted the number of RTAs significantly as well as sporting injuries due to lockdowns and cancellation of group gatherings[ 3 , 25 , 27 ]. Work injuries also decreased significantly due to lockdowns and remote work[ 26 , 28 ]. School traumas were reduced as students were engaged in online learning[ 24 , 26 ].…”

“…Elbardesy et al [ 28 ] investigated the impact of COVID-19 pandemic on trauma and orthopedic center in Ireland among 505 patients. The study was conducted between March 1, 2020 and April 14, 2020 and compared patients from 2019 in the same time period.…”

Increased Rate of Fracture Injuries Associated With Alternative Modes of Transportation During COVID-19

“…4-7 Considering this preexisting multifactorial rise in the use of AMTs, coupled with the shift toward conservative management for fracture injuries during COVID-19 to limit disease transmission, a thorough understanding of the trends and driving forces behind intrapandemic fracture injury rates will help direct care for the remainder of the COVID-19 pandemic and future pandemics alike. 8-10…”

“…[4][5][6][7] Considering this preexisting multifactorial rise in the use of AMTs, coupled with the shift toward conservative management for fracture injuries during COVID-19 to limit disease transmission, a thorough understanding of the trends and driving forces behind intrapandemic fracture injury rates will help direct care for the remainder of the COVID-19 pandemic and future pandemics alike. [8][9][10] This study seeks to evaluate whether the number of AMT-associated fracture injuries increased during the COVID-19 pandemic in the United States and assess its association with online search interest in AMTs. To that end, this study makes use of a novel method to approximate individual usage: online search probabilities.…”