How did restrictions mandated by the COVID-19 pandemic affect the performance of orthopedic trauma surgery in a Level-1 tertiary trauma hospital?

BACKGROUND: This present study was designed to evaluate the effect of restrictions on fracture admission to a Level-1 tertiary trauma hospital between COVID-19 pandemic and pre-pandemic restriction time intervals that included groups of younger than 65-years-old. METHODS: Patients who were hospitalized and treated for orthopedic treatment between 10 March and 1 June during the pandemic period were retrospectively analyzed. Control group consisted of patients admitted to the hospital in the same time interval in 2019. The patients were divided into three groups, under 20 years of age, between 20 and 65 years of age, and over 65 years of age. The patients’ data included age, gender, trauma mechanism, fracture type, and any COVID-19 radiological or clinical symptoms. RESULTS: The number of patients >65-years-old admitted to the orthopedic trauma center was high at pandemic intervals compared to pre-pandemic time. When the groups were compared for patients of 20–65-years-old; there was a significant difference for the fracture type (p

COVID-19 salgını sırasındaki kısıtlamalar üçüncü basamak travma hastanesinde ortopedik travma ameliyatlarını nasıl etkiledi?

AMAÇ: Bu çalışmanın amacı, birinci düzey üçüncü basamak travma hastanesinde 20 yaş altı, 20–65 yaş ve 65 yaş üstü hasta grupları için kısıtlamaların, COVID-19 pandemisi ve pandemi öncesi dönem arasındaki kırık başvurusu üzerindeki etkisini değerlendirmek amacıyla tasarlanmıştır. GEREÇ VE YÖNTEM: Pandemi döneminde 10 Mart–1 Haziran tarihleri arasında ortopedik tedavi için hastaneye kaldırılan ve tedavi edilen hastalar geriye dönük olarak incelendi. Kontrol grubu, 2019 yılında aynı zaman aralığında hastaneye başvuran hastalardan oluşturuldu. Hastalar 20 yaş altı, 20–65 yaş ve 65 yaş üstü olmak üzere üç gruba ayrıldı. Hastaların verileri yaş, cinsiyet, travma mekanizması, kırık tipi, herhangi bir COVID-19 radyolojik veya klinik semptomu içeriyordu. BULGULAR: Ortopedik travma merkezine başvuran 65 yaş üstü hasta sayısı pandemik aralıkta pre-pandemi zamanına göre yüksekti. Gruplar 20–65 yaş grubu hastalarla karşılaştırıldığında; kırık tipi açısından anlamlı fark vardı (p

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1. T. C. Ministry of Health. The Current Situation in Turkey; 2020. Available from: https://www.covid19.saglik.gov.tr. Accessed May 15, 2020.

2. Neher RA, Dyrdak R, Druelle V, Hodcroft EB, Albert J. Potential impact of seasonal forcing on a SARS-CoV-2 pandemic. Swiss Med Wkly 2020;150:w20224.

3. Zhu Y, Chen W, Xin X, Yin Y, Hu J, Lv H, et al. Epidemiologic characteristics of traumatic fractures in elderly patients during the outbreak of Coronavirus disease 2019 in China. Int Orthop 2020;44:1565–70.

4. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020;109:102433.

5. Singhal T. A review of Coronavirus disease-2019 (COVID-19). Indian J Pediatr 2020;87:281–6.

6. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA 2020;323:1406–7.

7. Coughlan T, Dockery F. Osteoporosis and fracture risk in older people. Clin Med (Lond) 2014;14:187–91.

8. Westbury LD, Syddall HE, Fuggle NR, Dennison EM, Cauley JA, Shiroma EJ, et al. Long-term rates of change in musculoskeletal aging and body composition: Findings from the health, aging and body composition study. Calcif Tissue Int 2020;106:616–24.

9. Zhang Q, Cai W, Wang G, Shen X. Prevalence and contributing factors of osteoporosis in the elderly over 70 years old: An epidemiological study of several community health centers in Shanghai. Ann Palliat Med 2020;9:231–8.

10. Turgut A, Arlı H, Altundağ Ü, Hancıoğlu S, Egeli E, Kalenderer Ö. Effect of COVID-19 pandemic on the fracture demographics: Data from a tertiary care hospital in Turkey. Acta Orthop Traumatol Turc 2020;54:355–63.

11. Bram JT, Johnson MA, Magee LC, Mehta NN, Fazal FZ, Baldwin KD, et al. Where have all the fractures gone? The epidemiology of pediatric fractures during the COVID-19 pandemic. J Pediatr Orthop 2020;40:373–9.

12. Joakimsen RM, Magnus JH, Fønnebø V. Physical activity and predisposition for hip fractures: A review. Osteoporos Int 1997;7:503–13.

13. Bérard A, Bravo G, Gauthier P. Meta-analysis of the effectiveness of physical activity for the prevention of bone loss in postmenopausal women. Osteoporos Int 1997;7:331–7.

14. Atik OŞ. There is an association between sarcopenia, osteoporosis, and the risk of hip fracture. Eklem Hastalik Cerrahisi 2019;30:1.

15. Atik OŞ, Aslan A, Odluyurt M. Are fragility fractures being treated properly? Jt Dis Relat Surg 2020;31:403–4.

16. Tang PF, Hou ZY, Wu XB, Zhang CQ, Wang JW, Xing X, et al. Expert consensus on management principles of orthopedic emergency in the epidemic of Coronavirus disease 2019. Chin Med J (Engl) 2020;133:1096– 8.

17. Wong JS, Cheung KM. Impact of COVID-19 on orthopaedic and trauma service: An epidemiological study. J Bone Joint Surg Am 2020;102:e80.

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