Abstract:

After a new type of coronavirus in Wuhan, China was found to cause deadly pneumonia, the World Health Organization declared the disease caused by the virus a pandemic on March 11, 2020. This situation led to the effectuation of some social restrictions that radically changed our daily lives in our country and across the world. This comprehensive change in social life also affected the daily practices in all branches of medicine as well as orthopedic trauma practice. The aim of this study was to evaluate the incidence, location, and treatment methods of the fractures seen in the pediatric and adult population during the pandemic period, and to investigate their differences with the pre-pandemic period. Our study was designed as a retrospective cohort study comparing the acute fractures admitted to our center during the pandemic period and the fractures that occurred before the pandemic. Patients who presented with a new fracture to our emergency ward or outpatient clinic between March 16, 2020, and December 30, 2020, when social restrictions were in effect in our country, were identified. Patients who applied to our center with a new fracture within the same date range in 2019 and 2018 were also identified. The patient group was determined by scanning the International Classification of Diseases code and orthopedic consultation charts on the database. After removing the duplicate records, the radiological examinations of all patients were evaluated by the researchers. The data regarding patients’ age, gender, fracture location, treatment types, length of hospital stay, and in-hospital mortality were recorded. The patients were divided into two groups: the pediatric group (16 years and younger) and the adult group (over 16 years). The total number of fractures in the pandemic period was significantly less than in the non-pandemic period (p<0.001). Although the number of fractures decreased significantly in both groups (p<0.001), there was no significant difference between the pandemic and non-pandemic period data regarding the age groups (p=0.771). The most common fracture sites were the distal radius (20% and 19.4%) and the ankle (8, 45% and 8.54%) in the non-pandemic period, while the distal radius (21.5%) and the proximal femur (10.8%) were the most involved sites in the pandemic period. The percentage of surgically treated fractures among all fractures was 49.6%, 46.6%, and 39.4% for 2018, 2019, and 2020, respectively. Although the prevalence of surgical treatments was lower in the pandemic period, the difference was not statistically significant (p=0.089). The mean length of hospital stay for the surgically treated fractures for all groups was 5.36±2.79, 5.78±2.41, and 4.10±1.62 days for the years 2018, 2019, and 2020, respectively. The decline in the length of stay during the pandemic period was found to be significant (p<0.001). We experienced some difficulties and confusion due to our lack of previous experience in orthopedic daily practices under the extraordinary conditions brought by the pandemic. We have seen how necessary and important previous experience can be in such extraordinary situations. The main motivation for us to carry out this study was to contribute to the knowledge in the literature. We observed a 26% decrease in the prevalence of fractures during the pandemic period. Although the indications for surgical treatment have not changed, we observed that the changes in the patient population and trauma mechanism also changed the treatment type.