Decrease in incidence of proximal femur fractures in the elderly population during the Covid-19 pandemic: a case–control study

Abstract

Background The World Health Organization classified Covid-19 as a pandemic during the first months of 2020 as lockdown measures were implemented globally to mitigate the increasing incidence of Covid-19-related morbidity and mortality. The purpose of this study was to evaluate the effect of national lockdown measures on proximal femur fracture epidemiology. Our hypothesis was that due to the prolonged period of stay-at-home orders, we would observe a decrease in the incidence of proximal femur fractures during the years 2020–21. Methods A retrospective case–control study of 2784 hip fractures admitted to the emergency department at one hospital between January 1, 2010, and March 31, 2021, was conducted. Cases were stratified weekly, and an analysis was conducted comparing cases occurring during government-imposed lockdown periods of 2020–21 to corresponding periods during 2010–2019. Furthermore, the trend of cases throughout the year of 2020 was observed. Results Of all proximal femur fracture cases included, 2522 occurred between 2010–2019 and 261 during the Covid-19 period. There was no significant difference in age (81.95 vs. 82.09; P = 0.78) or gender (P = 0.12). There was a total decrease of 21.64% in proximal femur fracture per week during the entirety of the Covid-19 pandemic period compared to the previous years (3.64 ± 1.99 vs. 4.76 ± 0.83; P = 0.001). During all three lockdown periods, there was a significant decrease in proximal femur fracture cases per week (3.55 ± 2.60 vs. 4.87 ± 0.95; P = 0.04), and the most pronounced decrease occurred during the third lockdown period (2.89 ± 1.96 vs. 5.23 ± 1.18; P = 0.01). Conclusion We observed a total decrease in the number of proximal femur fractures occurring during the Covid-19 era compared to previous years and specifically a decrease of cases occurring during the government-imposed lockdown periods. The decrease in cases was more pronounced during the second and third lockdown periods.

A Demographic Survey of Pertrochanteric Fractures Based on the Revised Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) Classification Using 3D CT Scan Images

“…The third limitation is the time period of the study (January 2015 to December 2020), which may be epidemiologically inaccurate due to the possible influence of COVID-19. However, we believe that our current demographical survey is less likely influenced by COVID-19 despite the inclusion of the year 2020, as proved by surveying reports [ 24 , 25 ].…”

Optimizing the Entry Point for Medullary Hip Screws

“…Proximal femur fracture or 'hip fracture' management continues to be an area of global interest even as recent evidence has suggested stabilizing or decreasing incidence. [14][15][16][17][18] Optimization of surgical technique to maximize functional recovery remains the cornerstone of multidisciplinary approaches developed to decrease morbidity and mortality after hip fractures. 16 Selecting the correct entry point is the most technically challenging and critical aspect of placing an medullary implant after reduction is obtained.…”

Disproportionately increased incidence of proximal femoral fractures in a level one trauma center

“…Im Jahr 2020, das v. a. durch die COVID-19-Pandemie und längere „Lockdowns“ gekennzeichnet war, wurden nicht weniger, sondern mehr proximale Femurfrakturen als in den Vorjahren behandelt. Dies steht im Gegensatz zu einem in der Literatur beschriebenen Rückgang der Inzidenzen proximaler Femurfrakturen auf nationaler und internationaler Ebene während des Beginns der COVID-19-Pandemie 2020 [ 2 , 7 , 10 ] und auch im Gegensatz zu einem Abfall der versorgten Patienten in der Notaufnahme der untersuchten Klinik im Jahr 2020 (Abb. 3 ).…”