CC BY 4.0 · Surg J (N Y) 2022; 08(04): e302-e307
DOI: 10.1055/s-0042-1757427
Original Article

The Impact of the COVID-19 Pandemic on Injury Patterns in Inpatient and Outpatient Orthopaedic Trauma

1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
,
Sharon Zammit
1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
,
Kurt L. Chircop
1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
,
Denise Gatt
1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
,
Luke Sultana
1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
,
Terence Micallef
1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
,
Adriana Grech
1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
,
Ivan Esposito
1   Department of Orthopaedics and Trauma, Mater Dei Hospital, L-Imsida, Malta
› Author Affiliations
Funding None.

Abstract

The effect of banning of nonessential services during the novel coronavirus disease 2019 (COVID-19) pandemic led to a perceived change in the volume of trauma cases and injury patterns. Literature indicates trends toward less trauma overall, with a decrease in outdoor, sporting, and motor vehicle injuries. However, studies focusing on outpatient orthopaedic trauma are less common. The main aim of this study was to assess the effect of COVID-19 pandemic on differences in inpatient and outpatient injury patterns and mechanisms. Patients requiring orthopaedic inpatient admission to Mater Dei Hospital, Malta, were analyzed between March 15 and June 17 between 2019 and 2021. For outpatients, all newly referred patients seen at the fresh trauma clinic (FTC) on the first 5 clinic days of each month from April to June between 2019 and 2021 were assessed. There were a total of 503, 362, and 603 hospital admissions during the data collection period from 2019, 2020 and 2021, respectively. There was a decrease in elbow (p = 0.015) and pelvis (p = 0.038) pathology since COVID-19 pandemic. In contrast, there was an increase in shoulder injuries (p = 0.036) and lacerated wounds (p = 0.012) in 2021. The most frequent mechanisms of injury for inpatients were low impact falls, and fall from heights greater than 1 m. Machine-related injuries (p = 0.002), blunt trauma (p = 0.004), and twisting injuries (p = 0.029) increased in 2021. In the outpatient setting, there were a total of 367, 232, and 299 new referrals in 2019, 2020, and 2021, respectively. Injury patterns in this cohort were similar throughout, except for a significant increase in shoulder injuries during 2020 (p = 0.009). There appears to be some minor variation in injury mechanisms due to lifestyle changes; however, most injury patterns have remained fairly constant. Further research should focus on the use of public awareness campaigns to decrease home-related trauma during enforced periods of lockdown.

Data Availability

The data that support the findings of this study are available from the corresponding author on reasonable request.




Publication History

Received: 06 May 2022

Accepted: 29 August 2022

Article published online:
26 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Chhabra HS, Bagaraia V, Keny S. et al. COVID-19: current knowledge and best practices for orthopaedic surgeons. Indian J Orthop 2020; 54 (04) 411-425
  • 2 Micallef S, Piscopo TV, Casha R. et al. The first wave of COVID-19 in Malta; a national cross-sectional study. PLoS One 2020; 15 (10) e0239389
  • 3 Lim MA, Mulyadi Ridia KG, Pranata R. Epidemiological pattern of orthopaedic fracture during the COVID-19 pandemic: a systematic review and meta-analysis. J Clin Orthop Trauma 2021; 16: 16-23
  • 4 Rajput K, Sud A, Rees M, Rutka O. Epidemiology of trauma presentations to a major trauma centre in the North West of England during the COVID-19 level 4 lockdown. Eur J Trauma Emerg Surg 2020
  • 5 Rozenfeld M, Peleg K, Givon A. et al. COVID-19 changed the injury patterns of hospitalized patients. Prehosp Disaster Med 2021; 36 (03) 251-259
  • 6 Bhat AK, Kamath K S. Comparative study of orthopaedic trauma pattern in covid lockdown versus non-covid period in a tertiary care centre. J Orthop 2021; 23: 1-7
  • 7 Berg GM, Wyse RJ, Morse JL. et al. Decreased adult trauma admission volumes and changing injury patterns during the COVID-19 pandemic at 85 trauma centers in a multistate healthcare system. Trauma Surg Acute Care Open 2021; 6 (01) e000642
  • 8 Waseem S, Nayar SK, Hull P. et al. The global burden of trauma during the COVID-19 pandemic: a scoping review. J Clin Orthop Trauma 2021; 12 (01) 200-207
  • 9 Zwaigenbaum L, Duku E, Fombonne E. et al. Developmental functioning and symptom severity influence age of diagnosis in Canadian preschool children with autism. Paediatr Child Health 2019; 24 (01) e57-e65
  • 10 Ross AG, Crowe SM, Tyndall MW. Planning for the next global pandemic. Int J Infect Dis 2015; 38: 89-94
  • 11 Stinner DJ, Lebrun C, Hsu JR, Jahangir AA, Mir HR. The orthopaedic trauma service and COVID-19: practice considerations to optimize outcomes and limit exposure. J Orthop Trauma 2020; 34 (07) 333-340
  • 12 Tay KJD, Lee YHD. Trauma and orthopaedics in the COVID-19 pandemic: breaking every wave. Singapore Med J 2020; 61 (08) 396-398
  • 13 McCloskey B, Zumla A, Ippolito G. et al; WHO Novel Coronavirus-19 Mass Gatherings Expert Group. Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma. Lancet 2020; 395 (10230): 1096-1099
  • 14 Yasin YJ, Grivna M, Abu-Zidan FM. Global impact of COVID-19 pandemic on road traffic collisions. World J Emerg Surg 2021; 16 (01) 51
  • 15 Cottrell MA, Russell TG. Telehealth for musculoskeletal physiotherapy. Musculoskelet Sci Pract 2020; 48: 102193
  • 16 Fiani B, Siddiqi I, Lee SC, Dhillon L. Telerehabilitation: development, application, and need for increased usage in the COVID-19 era for patients with spinal pathology. Cureus 2020; 12 (09) e10563