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 <20-years-old, 20–65-years-old, and older than aged >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<0.05). Lower extremity fractures were high at pre-pandemic group, whereas multiple traumas were high at pandemic group. For sub-group 20–65 ages, low-energy traumas were higher at pre-pandemic group, whereas high-energy traumas were more frequent at the pandemic group.
CONCLUSION: We observed a decrease in fracture admission to orthopedic trauma centers during COVID-19 pandemic for subgroups of <20-years-old and 20–65-years-old ages, whereas there was a significant increase for >65-years-old age, most of them related to the osteoporotic hip fractures. So that older age group should be encouraged to mobilize at home and have permission to walk and make physical activity to avoid osteoporosis for a limited time daily.

COVID-19 salgýný sýrasýndaki kýsýtlamalar üçüncü basamak travma hastanesinde ortopedik travma ameliyatlarýný nasýl etkiledi?

AMAÇ: Bu çalýþmanýn amacý, birinci düzey üçüncü basamak travma hastanesinde 20 yaþ altý, 20–65 yaþ ve 65 yaþ üstü hasta gruplarý için kýsýtlamalarýn, COVID-19 pandemisi ve pandemi öncesi dönem arasýndaki kýrýk baþvurusu üzerindeki etkisini deðerlendirmek amacýyla tasarlanmýþtýr.
GEREÇ VE YÖNTEM: Pandemi döneminde 10 Mart–1 Haziran tarihleri arasýnda ortopedik tedavi için hastaneye kaldýrýlan ve tedavi edilen hastalar geriye dönük olarak incelendi. Kontrol grubu, 2019 yýlýnda ayný zaman aralýðýnda hastaneye baþvuran hastalardan oluþturuldu. Hastalar 20 yaþ altý, 20–65 yaþ ve 65 yaþ üstü olmak üzere üç gruba ayrýldý. Hastalarýn verileri yaþ, cinsiyet, travma mekanizmasý, kýrýk tipi, herhangi bir COVID-19 radyolojik veya klinik semptomu içeriyordu.
BULGULAR: Ortopedik travma merkezine baþvuran 65 yaþ üstü hasta sayýsý pandemik aralýkta pre-pandemi zamanýna göre yüksekti. Gruplar 20–65 yaþ grubu hastalarla karþýlaþtýrýldýðýnda; kýrýk tipi açýsýndan anlamlý fark vardý (p<0.05). Pandemi öncesi grupta alt ekstremite kýrýklarý yüksek, pandemik grupta ise çoklu travmalar yüksekti. 20–65 yaþ alt gruplarýnda düþük enerjili travmalar pandemi öncesi grupta daha yüksek, yüksek enerjili travmalar pandemi grubunda daha sýktý.
TARTIÞMA: COVID-19 pandemisi sýrasýnda ortopedik travma merkezlerine kýrýk baþvurusunda 20 yaþ altý ve 20–65 yaþ alt gruplarýnda azalma, 65 yaþ ve üzeri için önemli bir artýþ görülürken, çoðu osteoporotik kalça kýrýklarý ile iliþkilidir. Bu nedenle ileri yaþ grubu, osteoporozdan kaçýnmak için her gün sýnýrlý bir süre için evde harekete geçmeye ve yürüme ve fiziksel aktivite yapma iznine sahip olmaya teþvik edilmelidir.