Course of Treatment and Short-Term Outcome of Surgically Treated Paediatric Upper Limb Fractures during the COVID-19 Pandemic—Experiences of a Level 1 Trauma Centre in Central Europe

Abstract

The COVID-19 pandemic and the resulting restrictions led to a reduced number of surgeries. This study examines its impact on the course of treatment and clinical outcome of surgically treated paediatric upper limb fractures during that specific period. This retrospective cohort study evaluated all children aged 0–18 years presenting with an upper limb fracture treated surgically at the level 1 trauma centre of the University Clinic of Orthopaedics and Trauma Surgery of Vienna within lockdown from 16 March to 29 May 2020 (definition applied through corresponding legislation) compared to the same period from 2015 to 2019. A total number of 127 children (m:63; f:44) were included. The lockdown did not lead to a significant increase in complications during and after initial surgery. Time until removal of implant was not significantly prolonged (p = 0.068; p = 0.46). The clinical outcome did not significantly differ compared to previous years. The experience of a level 1 trauma centre showed that despite reduced surgical capacity during the COVID-19 pandemic, no negative differences concerning course of treatment and clinical outcome of surgically treated paediatric upper limb fractures were present. These findings are still of importance since the COVID-19 pandemic continues and several countries in Central Europe are currently under their fourth lockdown.

The Swedish Perioperative Register: Description, validation of data mapping and utility

“…Thus, the reduced surgical resources were prioritized for these patients. This chosen strategy resembles the prioritization observed and reported in other studies 18–22 …”

“…This chosen strategy resembles the prioritization observed and reported in other studies. 18 , 19 , 20 , 21 , 22 …”

“…This chosen strategy resembles the prioritization observed and reported in other studies. [18][19][20][21][22] Furthermore, based on an analysis of preliminary data from the online reports retrievable from the SPOR database, spot-checks for some diagnoses indicate the patient groups with postponed surgery during this period were primarily those with benign or non-lifethreatening symptoms, such as pain from joint arthrosis or ENT problems in smaller children (Peter Spetz, personal communication). 22 Studies are needed to validate these theories and analyse the prioritization of surgical cancer cases during the COVID-19 pandemic.…”