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The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study

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...

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Autores principales: Hampton, Matthew, Clark, Matthew, Baxter, Ian, Stevens, Richard, Flatt, Elinor, Murray, James, Wembridge, Kevin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone and Joint Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684391/
https://www.ncbi.nlm.nih.gov/pubmed/33241224
http://dx.doi.org/10.1302/2633-1462.15.BJO-2020-0028.R1
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author Hampton, Matthew
Clark, Matthew
Baxter, Ian
Stevens, Richard
Flatt, Elinor
Murray, James
Wembridge, Kevin
author_facet Hampton, Matthew
Clark, Matthew
Baxter, Ian
Stevens, Richard
Flatt, Elinor
Murray, James
Wembridge, Kevin
author_sort Hampton, Matthew
collection PubMed
description 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.
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spelling pubmed-76843912020-11-24 The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study Hampton, Matthew Clark, Matthew Baxter, Ian Stevens, Richard Flatt, Elinor Murray, James Wembridge, Kevin Bone Jt Open General Orthopaedics 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. The British Editorial Society of Bone and Joint Surgery 2020-07-21 /pmc/articles/PMC7684391/ /pubmed/33241224 http://dx.doi.org/10.1302/2633-1462.15.BJO-2020-0028.R1 Text en © 2020 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/ Open Access This is an open-access article distributed under the terms of the Creative Commons Attributions licence (CC-BY-NC-ND), which permits unrestricted use, distribution, and reproduction in any medium, but not for commercial gain, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle General Orthopaedics
Hampton, Matthew
Clark, Matthew
Baxter, Ian
Stevens, Richard
Flatt, Elinor
Murray, James
Wembridge, Kevin
The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study
title The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study
title_full The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study
title_fullStr The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study
title_full_unstemmed The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study
title_short The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study
title_sort effects of a uk lockdown on orthopaedic trauma admissions and surgical cases: a multicentre comparative study
topic General Orthopaedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684391/
https://www.ncbi.nlm.nih.gov/pubmed/33241224
http://dx.doi.org/10.1302/2633-1462.15.BJO-2020-0028.R1
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