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Tarchala M, Bradley CS, Grant S, Verma Y, Camp M, Matava C, Kelley SP. The impact of public health lockdown measures during the COVID-19 pandemic on the epidemiology of children's orthopedic injuries requiring operative intervention. Can J Surg 2024; 67:E49-E57. [PMID: 38320778 PMCID: PMC10852194 DOI: 10.1503/cjs.002723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND In March 2020, Ontario instituted a lockdown to reduce spread of the SARS-CoV-2 virus. Schools, recreational facilities, and nonessential businesses were closed. Restrictions were eased through 3 distinct stages over a 6-month period (March to September 2020). We aimed to determine the impact of each stage of the COVID-19 public health lockdown on the epidemiology of operative pediatric orthopedic trauma. METHODS A retrospective cohort study was performed comparing emergency department (ED) visits for orthopedic injuries and operatively treated orthopedic injuries at a level 1 pediatric trauma centre during each lockdown stage of the pandemic with caseloads during the same date ranges in 2019 (prepandemic). Further analyses were based on patients' demographic characteristics, injury severity, mechanism of injury, and anatomic location of injury. RESULTS Compared with the prepandemic period, ED visits decreased by 20% (1356 v. 1698, p < 0.001) and operative cases by 29% (262 v. 371, p < 0.001). There was a significant decrease in the number of operative cases per day in stage 1 of the lockdown (1.3 v. 2.0, p < 0.001) and in stage 2 (1.7 v. 3.0; p < 0.001), but there was no significant difference in stage 3 (2.4 v. 2.2, p = 0.35). A significant reduction in the number of playground injuries was seen in stage 1 (1 v. 62, p < 0.001) and stage 2 (6 v. 35, p < 0.001), and there was an increase in the number of self-propelled transit injuries (31 v. 10, p = 0.002) during stage 1. In stage 3, all patient demographic characteristics and all characteristics of operatively treated injuries resumed their prepandemic distributions. CONCLUSION Provincial lockdown measures designed to limit the spread of SARS-CoV-2 significantly altered the volume and demographic characteristics of pediatric orthopedic injuries that required operative management. The findings from this study will serve to inform health system planning for future emergency lockdowns.
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Affiliation(s)
- Magdalena Tarchala
- From the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ont. (Tarchala, Bradley, Grant, Verma, Camp, Kelley); and the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ont. (Matava)
| | - Catharine S Bradley
- From the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ont. (Tarchala, Bradley, Grant, Verma, Camp, Kelley); and the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ont. (Matava)
| | - Samuel Grant
- From the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ont. (Tarchala, Bradley, Grant, Verma, Camp, Kelley); and the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ont. (Matava)
| | - Yashvi Verma
- From the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ont. (Tarchala, Bradley, Grant, Verma, Camp, Kelley); and the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ont. (Matava)
| | - Mark Camp
- From the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ont. (Tarchala, Bradley, Grant, Verma, Camp, Kelley); and the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ont. (Matava)
| | - Clyde Matava
- From the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ont. (Tarchala, Bradley, Grant, Verma, Camp, Kelley); and the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ont. (Matava)
| | - Simon P Kelley
- From the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ont. (Tarchala, Bradley, Grant, Verma, Camp, Kelley); and the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ont. (Matava)
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