Affiliation:
1. Trauma and Orthopaedics, Rotherham General Hospitals NHS Trust, Rotherham, UK
2. Trauma and Orthopaedics, Sheffield Children’s Hospital Sheffield Children’s NHS Foundation Trust, Sheffield, UK
3. Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
Abstract
Aims The current global pandemic due to COVID-19 is generating significant burden on the health service in the UK. On 23 March 2020, the UK government issued requirements for a national lockdown. The aim of this multicentre study is to gain a greater understanding of the impact lockdown has had on the rates, mechanisms and types of injuries together with their management across a regional trauma service. Methods Data was collected from an adult major trauma centre, paediatric major trauma centre, district general hospital, and a regional hand trauma unit. Data collection included patient demographics, injury mechanism, injury type and treatment required. Time periods studied corresponded with the two weeks leading up to lockdown in the UK, two weeks during lockdown, and the same two-week period in 2019. Results There was a 55.7% (12,935 vs 5,733) reduction in total accident and emergency (A&E) attendances with a 53.7% (354 vs 164) reduction in trauma admissions during lockdown compared to 2019. The number of patients with fragility fractures requiring admission remained constant (32 patients in 2019 vs 31 patients during lockdown; p > 0.05). Road traffic collisions (57.1%, n = 8) were the commonest cause of major trauma admissions during lockdown. There was a significant increase in DIY related-hand injuries (26% (n = 13)) lockdown vs 8% (n = 11 in 2019, p = 0.006) during lockdown, which resulted in an increase in nerve injuries (12% (n = 6 in lockdown) vs 2.5% (n = 3 in 2019, p = 0.015) and hand infections (24% (n = 12) in lockdown vs 6.2% (n = 8) in 2019, p = 0.002). Conclusion The national lockdown has dramatically reduced orthopaedic trauma admissions. The incidence of fragility fractures requiring surgery has not changed. Appropriate provision in theatres should remain in place to ensure these patients can be managed as a surgical priority. DIY-related hand injuries have increased which has led to an increased in nerve injuries requiring intervention.
Publisher
British Editorial Society of Bone & Joint Surgery
Subject
Pharmacology (medical),Complementary and alternative medicine,Pharmaceutical Science
Reference22 articles.
1. British Orthopaedic Association. Emergency BOAST: Management of patients with urgent orthopaedic conditions and trauma during the coronavirus pandemic. 2020. https://www.boa.ac.uk/resources/covid-19-boasts-combined.html
2. NHS England, (2020). Clinical guide for the management of trauma and orthopaedic patients during the coronavirus pandemic. 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0274-Specialty-guide-Orthopaedic-trauma-v2-14-April.pdf
3. NHS England, (2020). Clinical guide for the perioperative care of people with fragility fractures during the coronavirus pandemic. 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0086_Specialty-guide-_Fragility-Fractures-and-Coronavirus-v1-26-March.pdf
4. BLOOD-CONTAINING AEROSOLS GENERATED BY SURGICAL TECHNIQUES A POSSIBLE INFECTIOUS HAZARD
5. Emergency department. Weekly bulletins for 2020. https://www.gov.uk/government/publications/emergency-department-weekly-bulletins-for-2020
Cited by
80 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献