The Impact of COVID-19 on Hand Trauma

Abstract

Background The Coronavirus Disease 2019 (COVID-19) pandemic has had a dramatic impact on individual and societal behaviors, as well as on health care systems. It confers a unique opportunity to examine the relationship among disease, policies, and patterns of activity, as well as their impacts on surgical unit functionality. This study aims to compare the distribution and patterns of injury at a tertiary hand surgery trauma center before and during the COVID-19 pandemic. Methods A retrospective analysis of all patients presenting to the Royal North Shore Hospital hand surgery service in the 5-week period from March 16 to April 21 in 2019 and 2020 was undertaken, forming 2 cohorts for comparison. Demographic, injury, and operative data were collected and compared descriptively using comparative statistics. Results There were 114 primary operative presentations during the 5-week period in 2020, representing a 27.4% decrease from the 157 presentations during the equivalent period in 2019. There was an increase in the proportion of emergency presentations from 73.9% in 2019 to 85.1% in 2020 ( P = .03), with a corresponding decrease in elective presentations during 2020. The incidence of sporting injuries and motor vehicle accidents decreased in 2020, whereas falls and accidents involving knives and tools remained relatively constant. Operating times decreased in 2020, whereas the length of hospital stay remained constant. Conclusions The COVID-19 pandemic and consequent restrictions of activity have had substantial impacts on the patterns of hand trauma and its management. These insights have implications for staff and resource management during times of social disruption in the future.

The impact of COVID-19 on spinal cord injuries and trauma at a tertiary referral centre in Sydney

“…Westmead Hospital in Sydney, Australia, reported a 40% to 52% decrease in road trauma in 2020 when compared to the preceding period ( 15 ). The institution in the current study recorded similar trends in general orthopaedic and hand trauma from motor vehicle accidents in the same period ( 6 , 7 ). The increased proportion of cycling-related trauma is likely multifactorial, with the Sydney City Council reporting a monthly increase in rates of cycling traffic up to 50% in certain areas of Greater Sydney in April 2020, despite a reduction in overall people movement of 87% ( 16 ).…”

“…This study showed that neither time to theatre nor mean surgical time was significantly increased between the two cohorts [consistent with the prior literature]; however, time inside the operating theatre was significantly increased, which is most likely due to time required to implement the risk reduction strategies for aerosolising procedures ( 17 , 18 ). Interestingly, these findings are not consistent with operative intervention in general orthopaedic and hand trauma from the same institute, with total surgical time decreasing in both respective pandemic cohorts ( 6 , 7 ).…”

One Year of COVID-19: Lessons Learned in a Hand Trauma Center

“…The authors did not use telemedicine, and Toia et al [11] as well as Leti Acciaro et al [27] confirmed it might be an issue in Italy. To reduce contamination risks [28], some surgeons increased non-surgical treatment [9,23], and to resolve issues linked to a diminution of anesthetists' availability, many hand surgeons [9,12,14,17,24,29] stated to use WALANT surgery [30].…”

Influence on emergency digit replantation and outcome assessment after COVID-19 virus nucleic acid testing normalization

“…The COVID-19 pandemic and related policies have also shed impact on the frequency and disease distribution of emergency department visit because of the geographic restriction and changes in daily activities (4). As for hand trauma, although the incidence of emergency visit decreased globally in the first wave of the pandemic, the rate of emergency operation was reported unchanged and eventually the incidence returned to normal and remained unaffected by the following pandemic waves (5)(6)(7)(8).…”

“…Replantation of severed digits represents a hallmark in hand surgery, and survival rate of the digits has been increasing thanks to advances in microsurgery (9). Meanwhile, the rate of emergency digit replantation was reported to be relatively constant and even higher during waves of pandemic (4,5,10).…”