The effects of home confinement on pediatric fractures during the COVID 19 outbreak

Abstract

Objective To control the transmission of coronavirus disease 2019 (COVID-19), the Chinese government encouraged people to stay at home. This study aimed to evaluate the effects of home confinement on the occurrence of fractures among children. Study design We retrospectively reviewed children admitted to Children’s Hospital of Chongqing Medical University, for traumatic injury from January 24 to March 10, 2020, and the same time period in 2017, 2018 and 2019. At the same time, children with fracture were screened out and the date for the past 4 years was compared in terms of etiology, location of fracture, sex and age to evaluate the effects of home confinement on the epidemiology of pediatric fractures during the COVID-19 outbreak. Results There were 6066 fractures in5,346 patients in 2017–2019, and 1034 fractures in 862 patients in 2020; the number of patients in all years reached a peak at the age of 2 to 4 years. The patients were slightly younger in 2020 than in 2017–2019 (t = 9.953, 95% CI: 0.846–1.262), and the proportion of boys in 2017–2019 is higher than in 2020 (X2 = 6.944, P = 0.008). Home confinement and traffic restriction resulted in a reduction in traffic accidents-associated fractures among children (X2 = 16.399, P < 0.001). Conclusion Home confinement lead to the significant reduction in the number of pediatric fractures, especially in male children, but the number of patients under 4 years old was still considerable, and the proportion of younger patients even increased. Therefore, the perspective of children should not be relaxed during home isolation.

Compliance of functional exercises in school-age children with limb fractures: implication for nursing countermeasures

“…The general exercise method is from simple to complex, time from short to long, frequency from less to more, the intensity of exercise gradually increases, and the transition from passive exercise to active exercise gradually [ 41 , 42 ]. It is appropriate for the child to accept and not cause severe pain, and if necessary, give appropriate analgesics in accordance with the doctor's instructions before the exercise [ 43 , 44 ], so that the children can gradually adapt and not have fear of the pain caused by the functional exercise of the affected limb, and increase their compliance with the early functional exercise.…”

Prevalence of Vitamin D Deficiency in Children with Fractures: Before and during the COVID-19 Outbreak

“…The pediatric fracture volume has decreased during the COVID-19 pandemic, partially, because of the cessation of organized sports and decreased playground use. In China, home confinement led to a significant reduction in the number of pediatric fractures, which decreased from 5346 patients in 2017–2019 to 862 patients in 2020 [ 26 ]. A similar finding was observed in the Korean population.…”

Epidemiology of pediatric fractures before versus during the coronavirus disease 2019 pandemic

“…We retrospectively compared children admitted to a tertiary pediatric hospital in China [ 25 ] for traumatic injury between January 24 and March 10, 2020, to those admitted within the same period from 2017 to 2019. Children with fractures were compared in terms of etiology, fracture location, sex, and age to evaluate the effects of home confinement on the epidemiology of pediatric fractures during the COVID-19 pandemic.…”

“…A retrospective review in China [ 25 ] reported that the number of tibial fractures decreased from 208 to 52, femoral from 192 to 32, and fibular from 78 to 28, while the surgery rate changed from 9.38% to 34.38% for the femur and from 6.73% to 5.77% for the tibia. Although the overall number of pediatric lowerextremity fracture patients decreased, the change in the number of injured patients requiring surgery for treatment did not change significantly, suggesting increased numbers of surgeries.…”

“…A study in China [ 25 ] divided pediatric fracture patients into four age groups and noted a decrease in the number of fractures between the prepandemic and pandemic periods: infants (285 [14.40%] to 157 [18.21%], preschool children (657 [33.20%] to 344 [39.91%], school children (819 [41.38%] to 312 [36.19 %], and adolescents (218 [11.02%] to 49 [5.68%]). Due to COVID-19 lockdown measures, children were prohibited from attending school, and the proportion of pediatric patients who were relatively older and attend school has decreased significantly.…”