The Effects of the COVID-19 Pandemic on Pediatric Orthopedic Injuries: A Single-Center Retrospective Study.

IF 2 4区医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-10-19 DOI:10.3390/children11101265

Betina Hinckel, Sazid Hasan, Clark Yin, Jimmy Lau, Saeed Saleh, Ehab Saleh

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Abstract

Objectives: The COVID-19 pandemic has had a profound effect on the pediatric population worldwide. The consequences of the lockdown and the reallocation of hospital resources have caused notable changes in the presentation of pediatric orthopedic injuries. Through our use of patient records, we were able to display the epidemiological trends, as well as analyze the changes in the type and mechanism of various injuries. Our purpose is to further understand the considerable effects of the COVID-19 pandemic on pediatric orthopedic trauma and help guide the allocation of future healthcare resources.

Methods: We conducted a retrospective cohort study on pediatric patients admitted for any orthopedic injury over a 3-year period (September 2018 to August 2021) at a Midwest level 1 trauma center. Cases were stratified into two groups based on the United States' COVID-19 lockdown (19 March 2020): Pre-COVID-19 cases were any cases prior to the lockdown and Intra-COVID-19 which are cases following the lockdown. Numerical data and categorical variables were summarized and differences between the case groups were examined using either two-Proportion Z-Test, Independent Two-Sample t-test, Pearson's chi-squared, or Fisher's exact tests.

Results: A total of 3179 pediatric orthopedic referrals occurred between the Pre-COVID-19 and Intra-COVID-19 study periods. We observed a general decrease in orthopedic injuries following the COVID-19 lockdowns with 1235 injuries compared to 1606 Pre-COVID-19. Patterns in the locations of injuries changed; notably, fractures of the humerus, tibia, and fibula decreased significantly (p < 0.05). Several mechanisms of injuries decreased significantly following the onset of COVID-19 including injuries caused by monkey bars, basketball, and automobiles (p < 0.01). There was a significant increase in the overall injury severity during the Intra-COVID-19 period (p < 0.05).

Conclusions: Although there was a reduction in acute orthopedic trauma referrals, many injury mechanisms displayed similar trends regardless of restrictions. We clinically observed an overall increase in the severity of pediatric orthopedic injuries during the COVID-19 pandemic.

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COVID-19 大流行对小儿骨科损伤的影响：单中心回顾性研究

目标：COVID-19 大流行对全球儿科人群产生了深远影响。封锁的后果和医院资源的重新分配使儿科骨科损伤的表现形式发生了显著变化。通过使用患者记录，我们能够显示流行病学趋势，并分析各种损伤类型和机制的变化。我们的目的是进一步了解 COVID-19 大流行对小儿骨科创伤的巨大影响，并帮助指导未来医疗资源的分配：我们对中西部一家一级创伤中心 3 年内（2018 年 9 月至 2021 年 8 月）因任何骨科损伤入院的儿科患者进行了一项回顾性队列研究。根据美国 COVID-19 封锁（2020 年 3 月 19 日）将病例分为两组：Pre-COVID-19病例为封锁前的所有病例，Intra-COVID-19病例为封锁后的病例。对数字数据和分类变量进行汇总，并使用两比例 Z 检验、独立两样本 t 检验、皮尔森卡方检验或费雪精确检验来检验病例组之间的差异：结果：COVID-19 研究前和研究中期间，共有 3179 例儿科骨科转诊。我们观察到，在 COVID-19 封锁后，骨科伤害事件普遍减少，与 COVID-19 前的 1606 起相比，减少了 1235 起。受伤部位的模式也发生了变化；肱骨、胫骨和腓骨骨折明显减少（p < 0.05）。在 COVID-19 启用后，几种受伤机制明显减少，包括单杠、篮球和汽车造成的伤害（p < 0.01）。在 COVID-19 期间，总体受伤严重程度明显增加（P < 0.05）：结论：虽然急性骨科创伤的转诊率有所下降，但许多损伤机制显示出相似的趋势，而不受任何限制。我们在临床上观察到，在 COVID-19 大流行期间，小儿骨科创伤的严重程度总体上有所上升。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Children-Basel PEDIATRICS-

CiteScore

2.70

自引率

16.70%

发文量

1735

审稿时长

6 weeks

期刊介绍： Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.