TY - JOUR
T1 - The COVID-19 Pandemic
T2 - Effects on Pediatric Fracture Patterns in the Emergency Department and Subspecialty Follow-up Care
AU - Lapsa, Julianne
AU - Bukola Badaki, Oluwakemi
AU - Xu, Amy
AU - Eaton, Cyd
AU - Jay Lee, R.
AU - Ryan, Leticia
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Purpose: The COVID-19 pandemic affected pediatric fracture injury patterns and volume. There is a paucity of research evaluating this trend throughout the pandemic and also follow-up to orthopaedic subspecialty care after emergency fracture management. Methods: This retrospective cohort study reviewed patients 2 to 18 years of age presenting for fracture care to an urban pediatric emergency department. We assessed patient demographics, clinical care, and follow-up to surgical subspecialist. Time periods investigated included March 30 to September 4, 2020 (pandemic), March 30 to September 4, 2019, and March 30 to September 4, 2018 (prepandemic). Subanalysis within the pandemic was during the "stay-at-home order" verses the phased re-opening of the state. Descriptive statistical analysis, Pearson's χ2or Fisher exact tests, and Mann-Whitney U tests were performed. Results: In this population, fractures overall declined by 40% (n=211) during the pandemic compared with 2019 (n=349) and 28% compared with 2018 (n=292). Lower extremity fractures accounted for a greater percentage of injuries during the pandemic compared with prepandemic. Time to surgical subspecialty follow-up was shortest during the 2020 pandemic peak at 9 days and was significantly longer during phased reopening (phase 1: 18 d, P=0.001; phase 2: 14 d, P=0.005). These patterns were also consistent for days to repeat imaging. Conclusions: We found differences in fracture prevalence, mechanisms, and follow-up care during the pandemic. Time to subspecialty follow-up care was longer during pandemic phased reopening despite overall fewer fractures. Plans to absorb postponed visits and efficiently engage redeployed staff may be necessary to address difficulties in follow-up orthopaedic management during public health crises. Level of Evidence: Level II.
AB - Purpose: The COVID-19 pandemic affected pediatric fracture injury patterns and volume. There is a paucity of research evaluating this trend throughout the pandemic and also follow-up to orthopaedic subspecialty care after emergency fracture management. Methods: This retrospective cohort study reviewed patients 2 to 18 years of age presenting for fracture care to an urban pediatric emergency department. We assessed patient demographics, clinical care, and follow-up to surgical subspecialist. Time periods investigated included March 30 to September 4, 2020 (pandemic), March 30 to September 4, 2019, and March 30 to September 4, 2018 (prepandemic). Subanalysis within the pandemic was during the "stay-at-home order" verses the phased re-opening of the state. Descriptive statistical analysis, Pearson's χ2or Fisher exact tests, and Mann-Whitney U tests were performed. Results: In this population, fractures overall declined by 40% (n=211) during the pandemic compared with 2019 (n=349) and 28% compared with 2018 (n=292). Lower extremity fractures accounted for a greater percentage of injuries during the pandemic compared with prepandemic. Time to surgical subspecialty follow-up was shortest during the 2020 pandemic peak at 9 days and was significantly longer during phased reopening (phase 1: 18 d, P=0.001; phase 2: 14 d, P=0.005). These patterns were also consistent for days to repeat imaging. Conclusions: We found differences in fracture prevalence, mechanisms, and follow-up care during the pandemic. Time to subspecialty follow-up care was longer during pandemic phased reopening despite overall fewer fractures. Plans to absorb postponed visits and efficiently engage redeployed staff may be necessary to address difficulties in follow-up orthopaedic management during public health crises. Level of Evidence: Level II.
KW - clinic care
KW - emergency care
KW - fracture
KW - pandemic
UR - http://www.scopus.com/inward/record.url?scp=85139738827&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85139738827&partnerID=8YFLogxK
U2 - 10.1097/BPO.0000000000002222
DO - 10.1097/BPO.0000000000002222
M3 - Article
C2 - 36112844
AN - SCOPUS:85139738827
SN - 0271-6798
VL - 42
SP - 582
EP - 588
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
IS - 10
ER -