Increased orthopaedic presentations as a result of COVID‐19‐related social restrictions in a regional setting, despite local and global trends. Issue 7 (20th May 2021)

• Record Type: Journal Article
• Authors: Woo, Elise; Smith, Ariella Jessica; Mah, Dominic; Pfister, Benjamin Francis; Drobetz, Herwig
• Is Part Of: ANZ journal of surgery. Volume 91:Issue 7/8(2021)
• Page Start: 1369
• Page End: 1375
• Publication Date: 2021-05-20
• Subjects: COVID‐19 -- emergency -- orthopaedics -- regional -- rural -- trauma; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.16928
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: The coronavirus (COVID‐19) pandemic has affected the utilisation of emergency department (ED) services worldwide. The aim of this study was to assess the impact of COVID‐19‐related public health measures on orthopaedic presentations to a regional Australian hospital. Methods: A case–control study was performed at a regional trauma hospital in New South Wales (NSW), Australia. Data was collected prospectively from patients that required orthopaedic review in the period corresponding to a declaration of a global pandemic to the end of the NSW lockdown, and compared with retrospective data from the corresponding period in 2019. The five‐year average of orthopaedic presentations to ED during the study period were obtained for comparison. The primary outcomes were overall number of presentations, mechanism and anatomical location of injuries, operative versus non‐operative management and disposition. Results: During the study period in 2020, presentations requiring orthopaedic review were significantly more frequent than 2019 (496 vs. 280, p < 0.0001), with more requiring admission in 2020 ( p < 0.0001). The absolute number of patients managed operatively was higher ( p = 0.0002) and significantly more patients were referred for community follow‐up ( p < 0.0001). There was a 20% increase of consults in 2020 compared to the average number of referrals during the same period in the previous five years. Conclusions: Contrary to other published literature, lockdown conditions imposed during the COVID‐19 pandemic resulted in a surprising 77% increase in orthopaedic presentations to this regional Australian hospital. These findings can be used to better direct resources, preparation and staff education in the current and for future pandemics. Abstract : The coronavirus disease 2019 pandemic and its associated public health measures has had an impact on orthopaedic presentations worldwide. Contrary to worldwide studies suggesting a reduction in orthopaedic referrals and admissions during this period, our observational cohort study found a 20% increase in orthopaedic presentations to a regional emergency department compared to the preceding 5‐year average. The trends and observations may be utilised to assist with future resource allocation and departmental planning for orthopaedic services, staff and funding between urban and regional centres during global pandemics.