The effect of the COVID-19 lockdown on hand trauma surgery utilization

Abstract

Aims The aim of this study was to evaluate the need for hand trauma services during the COVID-19 pandemic lockdown, specifically related to surgical requirements. This will provide useful information for planning and resource allocation in the event of any further lockdown. Methods A prospective analsysis of all patients attending our hand trauma unit throughout the UK COVID-19 lockdown period (24 March to 10 May 2020) was carried out. Prospectively collected departmental data from the same period in 2019 was obtained and reviewed for comparison. The number of patients attending clinic, undergoing surgery, the type of surgical procedure, and rate of surgery was compared. Results In all, 463 patients attended hand trauma services during the lockdown period compared to 793 in 2019 (32% reduction); 190 surgical procedures were carried out during lockdown compared to 236 in 2019 (20% reduction). Intervention rate was higher during the lockdown period (41% compared to 30%). There was no difference in the type of cases. In the first half of lockdown, 47% fewer procedures were performed than in 2019, but in the second half of lockdown 13% more procedures were carried out than the same period in 2019. Conclusion Requirements for hand trauma surgery remain high during a pandemic lockdown. Attendances and surgical requirements can be expected to steadily return to normal levels during a prolonged lockdown period. Throughout any future lockdown period adequate surgical provision must be maintained for patients with hand injuries.

Risk of surgical site infection in hand trauma, and the impact of the SARS-CoV-2 pandemic: A cohort study

“…These findings are reflected in other studies examining hand trauma during the COVID-19 pandemic. 19 , 25 Discourse looking at the specific activity implicated have suggested that sports related trauma was reduced whilst domestic ‘do-it-yourself’ (DIY) injuries and injuries related to deliberate self-harm (DSH) were more prevalent. 19 , 25 , 26 …”

Changes in Pediatric Fracture Cases during the Coronavirus Disease 2019 Pandemic: Data from a National Referral Orthopedic Hospital in Indonesia

“…Along with the WHO interim guidance, this finding indicates that inpatient admission processes may need to be adjusted as the risks and benefits of hospital-based care change suggest that inpatient admission processes may need to be modified [25]. Other studies from many countries also uncovered a decrease in patient's length of stay due to pandemic [26], [27]. Discharge planning coordinated with primary care follow-up can also help to shorten hospital stays.…”

Violent trauma as an indirect impact of the COVID-19 pandemic: A systematic review of hospital reported trauma

“…35 , 36 The majority of studies were based in urban locations, with heavy bias towards high-income countries, including the United States (n = 14), 17 , 18 , 19 , 22 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 37 , 38 , 39 Australia (n = 2), 23 , 34 and Western Europe (n = 18). 20 , 21 , 24 , 26 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 Records were examined visually via placement of study results onto a world map. All eight studies showing an increase in violence were based in the United States.…”