Volume of pediatric fractures declines during COVID-19 pandemic
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The volume of visits for pediatric fractures decreased by 2.5 fold during the COVID-19 pandemic at one pediatric trauma hospital, mostly due to a decrease in playground use and less participation in organized sports, researchers said.
The findings from a retrospective cohort study were presented at AAP National Conference & Exhibition.
Medical student Joshua T. Bram, MS, and Apurva S. Shah, MD, MBA, an orthopedic surgeon at the Children’s Hospital of Philadelphia, assessed patients presenting with acute fractures from March 15 to April 15, 2020, and compared it with patients from the same time period in both 2018 and 2019. A total of 1,745 cases were included.
During the pandemic, the researchers observed a decrease in the incidence of daily fractures at the hospital compared with past years — 22.5 + 9.1 per day in past years vs. 9.6 + 5.1 per day in 2020. The number of fractures requiring surgery also decreased — 2.2 ± 1.8 per day vs. 0.8 ± 0.8 per day.
According to the findings, there was a decrease in the proportion of fractures relating to organized sports (26% vs. 7.2%) and playgrounds (9% vs. 5.2%).
The researchers also reported an increase in the proportion of injuries that occurred at home (57.8% vs. 32.5%) or on bicycles (18.3% vs. 8.2%) during the pandemic, compared with previous years.
“Because of the increased proportion of injuries occurring at home, including those resulting from high-energy falls such as trampoline-related fractures, and on bicycles, parents should be aware of the risk of injury while children are at home in an effort to keep their children safe,” Bram and Shah told Healio. “It is also important for large national groups such as the AAP and Pediatric Orthopaedic Society of North America to focus injury prevention efforts on these increasingly common injury mechanisms.”
The researchers noted that they were able to treat distal radius torus fractures with Velcro splints during the pandemic, more than they were in past years (44.2% vs 25.9%).
“An increase in the use of durable Velcro splints for distal radius torus fractures during the pandemic, over traditional casting, minimizes the in-person follow-up that could put someone at risk of contracting COVID-19,” they said.
Shah and Bram said it is likely that pediatric fractures will increase after the pandemic is over and “with the resumption of in-person schooling and sporting activities, though it is certainly unclear at this point when this pandemic will truly end.”
“Additionally, it is likely that there will be a gradual resumption of normal schooling, sports and activities as an effective vaccine becomes widely available, and therefore there may be more of a gradual increase in fracture incidence,” they said.