Initial Impact of the COVID-19 Pandemic on a US Orthopaedic Foot and Ankle Clinic

Abstract

Background: In the United States, the COVID-19 pandemic led to a nationwide quarantine that forced individuals to adjust their daily activities, potentially impacting the burden of foot and ankle disease. The purpose of this study was to compare diagnoses made in an orthopaedic foot and ankle clinic during the shelter-in-place period of the COVID-19 pandemic to diagnoses made during the same months of the previous year. Methods: A retrospective review of new patients presenting to the clinics of 4 fellowship-trained orthopaedic foot and ankle surgeons in a major United States city was performed. Patients in the COVID-19 group presented between March 22 and July 1, 2020, during the peak of the quarantine for this city. Patients in the control group presented during the same period of 2019. Final diagnosis, chronicity of symptoms (acute: ≤1 month), and mechanism of disease were compared between groups. Results: A total of 1409 new patient visits were reviewed with 449 visits in the COVID-19 group and 960 visits in the control group. The COVID-19 group had a significantly higher proportion of ankle fractures (8.7% vs 5.4%, P = .020) and stress fractures (4.2% vs 2.2%, P = .031), but a smaller proportion of Achilles tendon ruptures (0.7% vs 2.5%, P = .019). The COVID-19 group had a higher proportion of acute injuries (35.4% vs 23.5%, P < .001). Conclusion: There was a shift in prevalence of pathology seen in the foot and ankle clinic during the COVID-19 pandemic, which may reflect the adoption of different activities during the quarantine period and reluctance to present for evaluation of non-urgent injuries. Level of Evidence: Level III, retrospective cohort study.

Effects of the SARS-CoV-2 pandemic on the incidence of surgically treated fractures in Sao Paulo city

“…In the first year of COVID-19, the incidence of surgical fractures in Sao Paulo city decreased, as did the lower limb surgical fractures. The reduction may be due to the isolation applied in the city that reduced the chance of high-energy traumas such as automobile accidents, falls from great heights, or sports traumas (16,17) . This decrease in incidence was seen in most studies that described the initial phase of COVID-19 (8)(9)(10)(11)(12)(13)16,17) .…”

“…The reduction may be due to the isolation applied in the city that reduced the chance of high-energy traumas such as automobile accidents, falls from great heights, or sports traumas (16,17) . This decrease in incidence was seen in most studies that described the initial phase of COVID-19 (8)(9)(10)(11)(12)(13)16,17) . However, malleolar and talar fractures, considered high-energy trauma, increased during this period and may be associated with changes in patient habits during the isolation period.…”

Effect of the COVID-19 Pandemic on Lower Extremity Injuries in Japanese Collegiate Men’s Basketball Players

“…A retrospective review of new patients in the city of Chicago reported a significantly higher proportion of ankle fractures and stress fractures than those during the same months before the COVID-19 pandemic. 15 As there are no epidemiological studies available on Japanese collegiate men's basketball players during the COVID-19 pandemic, the purpose of the current study was to describe the incidence of lower extremity injuries in this population during 2 seasons affected by the pandemic (2020-21 and 2021-22). Lower extremity injuries were chosen, as they have been reported as the most frequent in basketball.…”

“… 19 Several studies have reported the effects of the COVID-19 pandemic on lower extremity injuries. 4 , 15 , 16 , 19 Demir et al 4 showed the risk for muscle injuries due to long-term detraining by COVID-19 confinement in professional soccer players. A retrospective review of new patients in the city of Chicago reported a significantly higher proportion of ankle fractures and stress fractures than those during the same months before the COVID-19 pandemic.…”

“…A retrospective review of new patients in the city of Chicago reported a significantly higher proportion of ankle fractures and stress fractures than those during the same months before the COVID-19 pandemic. 15 …”