Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study
Sinan Oguzkaya1
, Abdulhamit Misir2, Mustafa Ozcamdalli2, Gokay Eken3, Turan Bilge Kizkapan4, Muhammed Bilal Kurk2, Erdal Uzun5
1Department of Orthopedics and Traumatology, Sarkışla State Hospital, Sivas, Turkey
2Department of Orthopedics and Traumatology, Başaksehir Çam and Sakura City Hospital, Istanbul, Turkey
3Department of Orthopedics and Traumatology, Bursa Acıbadem Hospital, Bursa, Turkey
4Department of Orthopedics and Traumatology, Çekirge State Hospital, Bursa, Turkey
5Department of Orthopedics and Traumatology, Erciyes University School of Medicine, Kayseri, Turkey
Keywords: COVID-19, epidemiology, fracture, orthopedic, pandemic, trauma
Abstract
Objectives: The aim of this study was to evaluate the impact of novel coronavirus-2019 (COVID-19) on the epidemiological characteristics of orthopedic fractures.
Patients and methods: A total of 2,960 patients (1,755 males, 1,205 females; mean age: 39.6 years; range, 1 to 98 years) with orthopedic fractures were included in the study: 552 patients during the pandemic period (March 10th and July 1st, 2020) and 1,158 control patients in the same period 2019 and 1,250 control patients in 2018. Epidemiological characteristics, injury mechanisms, fracture locations and treatment details of the patients were analyzed and compared between 2018, 2019 and 2020 for adult and pediatric populations.
Results: Of a total of 552 patients, 485 were adults and 67 were pediatric patients. In the control groups, of 1,158 patients (2019), 770 were adults and 378 were pediatric patients and, of 1,250 patients (2018), 857 were adults and 393 were pediatric patients. The proportion of proximal femur and hand fractures significantly increased during the pandemic period (p=0.025 and p=0.038, respectively). The most frequent surgical indication in the pandemic period was proximal femoral fracture. The proportion of home accidents as an injury mechanism significantly increased in the pandemic period compared to 2018 and 2019 (48.5% vs. 18.6% and 20.6%, respectively; p=0.000). The proportion of female pediatric patients significantly increased during the pandemic period compared to 2018 and 2019 (44.8% vs. 25.4% and 27.2%, respectively, p=0.004). The proportion of forearm fractures (p=0.001) also increased, and the proportion of tibia-fibula fractures (p=0.03) decreased. The most frequent surgical indication in pediatric patients was distal humeral fracture in both groups.
Conclusion: During the pandemic period, proximal femoral fractures in the elderly remained a concern. In-home preventative strategies may be beneficial to reduce the incidence of hip fractures in the elderly.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.