The impact of COVID-19 on the epidemiologic characteristics of traumatic fractures: A systematic review of recent literature

Objective: The aim of this study was to evaluate whether COVID-19-related period of societal restrictions and nationwide in 2020 were associated with a significant change in types and frequency of traumatic fractures. Methods: A systematic review of recent literature on epidemiologic characteristics of traumatic fractures during the outbreak of COVID-19 was conducted. Multiple databases of PubMed, EMBASE, Cochrane library, and Web of Science were searched, and articles comparing incidence for traumatic fractures before and after of COVID-19 outbreak were included. Results: From 8 published studies which had been reported from July 2020 to September 2020, a total of 9305 patients were identified. The study period of each study included varied from January 24 to May 22 in 2020. There was a significant decrease in the total number of trauma cases during lockdown by 3229 cases (pre-lockdown n = 6267 and lockdown n = 3038), amounting to a decrease by a pooled percentage of 51.6% (P = 0.012). The incidence of hand and tibia fractures decreased while the incidence of femoral fracture significantly increased during COVID-19 outbreak (P < 0.001). There was no significant difference in the fracture frequency for all other skeletal areas (P > 0.05). Conclusion: Evidence suggests that there was a significant decrease in the overall number of traumatic fractures during the COVID-19-related period of societal restrictions and lockdown. Proportions of most fractured areas were not significantly influenced by the state of emergency, except for femoral fractures, which had occurred more often during this state. Care must be taken, while developing contingency plans for reallocating resources during the COVID-19 pandemic, not to assume that all trauma presentations will decrease. Evidence from this study has suggested there was a significant decrease in the overall number of traumatic fractures during the COVID-19-related period of societal restrictions and lockdown. Proportions of most fractured areas were not significantly influenced by the state of emergency, except for femoral fractures which had occurred more often during this state.

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