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Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland

AIMS: The UK government declared a national lockdown on 23 March 2020 to reduce transmission of COVID-19. This study aims to identify the effect of lockdown on the rates, types, mechanisms, and mortality of musculoskeletal trauma across Scotland. METHODS: Data for all musculoskeletal trauma requirin...

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Autores principales: MacDonald, David R. W., Neilly, David W., Davies, Peter S. E., Crome, Christopher R., Jamal, Bilal, Gill, Sarah L., Jariwala, Arpit C., Stevenson, Iain M., Ashcroft, G. Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659679/
https://www.ncbi.nlm.nih.gov/pubmed/33215152
http://dx.doi.org/10.1302/2633-1462.19.BJO-2020-0114.R1
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author MacDonald, David R. W.
Neilly, David W.
Davies, Peter S. E.
Crome, Christopher R.
Jamal, Bilal
Gill, Sarah L.
Jariwala, Arpit C.
Stevenson, Iain M.
Ashcroft, G. Patrick
author_facet MacDonald, David R. W.
Neilly, David W.
Davies, Peter S. E.
Crome, Christopher R.
Jamal, Bilal
Gill, Sarah L.
Jariwala, Arpit C.
Stevenson, Iain M.
Ashcroft, G. Patrick
author_sort MacDonald, David R. W.
collection PubMed
description AIMS: The UK government declared a national lockdown on 23 March 2020 to reduce transmission of COVID-19. This study aims to identify the effect of lockdown on the rates, types, mechanisms, and mortality of musculoskeletal trauma across Scotland. METHODS: Data for all musculoskeletal trauma requiring operative treatment were collected prospectively from five key orthopaedic units across Scotland during lockdown (23 March 2020 to 28 May 2020). This was compared with data for the same timeframe in 2019 and 2018. Data collected included all cases requiring surgery, injury type, mechanism of injury, and inpatient mortality. RESULTS: A total of 1,315 patients received operative treatment from 23 March 2020 to 28 May 2020 compared with 1,791 in 2019 and 1,719 in 2018. The numbers of all injury types decreased, but the relative frequency of hip fractures increased (36.3% in 2020 vs 30.2% in 2019, p < 0.0001 and 30.7% in 2018, p < 0.0001). Significant increases were seen in the proportion of DIY-related injuries (3.1% in 2020 vs 1.7% in 2019, p = 0.012 and 1.6% in 2018, p < 0.005) and injuries caused by falls (65.6% in 2020 vs 62.6% in 2019, p = 0.082 and 61.9% in 2018, p = 0.047). Significant decreases were seen in the proportion of road traffic collisions (2.6% in 2020 vs 5.4% in 2019, p < 0.0001 and 4.2% in 2018, p = 0.016), occupational injuries (1.8% in 2020 vs 3.0% in 2019, p = 0.025 and 2.3% in 2018, p = 0.012) and infections (6.8% in 2020 vs 7.8% in 2019, p = 0.268 and 10.3% in 2018, p < 0.012). Cycling injuries increased (78 in 2020 vs 64 in 2019 vs 42 in 2018). A significant increase in the proportion of self-harm injuries was seen (1.7% in 2020 vs 1.1% in 2019, p = 0.185 and 0.5% in 2018, p < 0.0001). Mortality of trauma patients was significantly higher in 2020 (5.0%) than in 2019 (2.8%, p = 0.002) and 2018 (1.8%, p < 0.0001). CONCLUSION: The UK COVID-19 lockdown has resulted in a marked reduction in musculoskeletal trauma patients undergoing surgery in Scotland. There have been significant changes in types and mechanisms of injury and, concerningly, mortality of trauma patients has risen significantly. Cite this article: Bone Joint Open 2020;1-9:541–548.
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spelling pubmed-76596792020-11-18 Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland MacDonald, David R. W. Neilly, David W. Davies, Peter S. E. Crome, Christopher R. Jamal, Bilal Gill, Sarah L. Jariwala, Arpit C. Stevenson, Iain M. Ashcroft, G. Patrick Bone Jt Open General Orthopaedics AIMS: The UK government declared a national lockdown on 23 March 2020 to reduce transmission of COVID-19. This study aims to identify the effect of lockdown on the rates, types, mechanisms, and mortality of musculoskeletal trauma across Scotland. METHODS: Data for all musculoskeletal trauma requiring operative treatment were collected prospectively from five key orthopaedic units across Scotland during lockdown (23 March 2020 to 28 May 2020). This was compared with data for the same timeframe in 2019 and 2018. Data collected included all cases requiring surgery, injury type, mechanism of injury, and inpatient mortality. RESULTS: A total of 1,315 patients received operative treatment from 23 March 2020 to 28 May 2020 compared with 1,791 in 2019 and 1,719 in 2018. The numbers of all injury types decreased, but the relative frequency of hip fractures increased (36.3% in 2020 vs 30.2% in 2019, p < 0.0001 and 30.7% in 2018, p < 0.0001). Significant increases were seen in the proportion of DIY-related injuries (3.1% in 2020 vs 1.7% in 2019, p = 0.012 and 1.6% in 2018, p < 0.005) and injuries caused by falls (65.6% in 2020 vs 62.6% in 2019, p = 0.082 and 61.9% in 2018, p = 0.047). Significant decreases were seen in the proportion of road traffic collisions (2.6% in 2020 vs 5.4% in 2019, p < 0.0001 and 4.2% in 2018, p = 0.016), occupational injuries (1.8% in 2020 vs 3.0% in 2019, p = 0.025 and 2.3% in 2018, p = 0.012) and infections (6.8% in 2020 vs 7.8% in 2019, p = 0.268 and 10.3% in 2018, p < 0.012). Cycling injuries increased (78 in 2020 vs 64 in 2019 vs 42 in 2018). A significant increase in the proportion of self-harm injuries was seen (1.7% in 2020 vs 1.1% in 2019, p = 0.185 and 0.5% in 2018, p < 0.0001). Mortality of trauma patients was significantly higher in 2020 (5.0%) than in 2019 (2.8%, p = 0.002) and 2018 (1.8%, p < 0.0001). CONCLUSION: The UK COVID-19 lockdown has resulted in a marked reduction in musculoskeletal trauma patients undergoing surgery in Scotland. There have been significant changes in types and mechanisms of injury and, concerningly, mortality of trauma patients has risen significantly. Cite this article: Bone Joint Open 2020;1-9:541–548. The British Editorial Society of Bone & Joint Surgery 2020-09-08 /pmc/articles/PMC7659679/ /pubmed/33215152 http://dx.doi.org/10.1302/2633-1462.19.BJO-2020-0114.R1 Text en © 2020 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle General Orthopaedics
MacDonald, David R. W.
Neilly, David W.
Davies, Peter S. E.
Crome, Christopher R.
Jamal, Bilal
Gill, Sarah L.
Jariwala, Arpit C.
Stevenson, Iain M.
Ashcroft, G. Patrick
Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland
title Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland
title_full Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland
title_fullStr Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland
title_full_unstemmed Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland
title_short Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland
title_sort effects of the covid-19 lockdown on orthopaedic trauma: a multicentre study across scotland
topic General Orthopaedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659679/
https://www.ncbi.nlm.nih.gov/pubmed/33215152
http://dx.doi.org/10.1302/2633-1462.19.BJO-2020-0114.R1
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