Submitting/Presenting Author

Kirsten NorrellFollow

Presenter Status

Resident/Psychology Intern

Abstract Type

Research

Primary Mentor

Mark Sinclair, MD

Start Date

12-5-2021 11:30 AM

End Date

12-5-2021 1:30 PM

Presentation Type

Poster Presentation

Description

Background: School and playground closures and the cancellation of extracurricular activities in the Kansas City region on March 17, 2020 due to the COVID-19 pandemic created an unprecedented situation for children and parents. Early reports in the literature on adult and pediatric trauma volume suggested a decrease in orthopaedic injuries during the pandemic. This is the first study to report how the pandemic affected orthopaedic trauma volume at a Level 1 pediatric trauma center during the entire five months since school and activity closures went into effect.

Objectives/Goal: The aim of this study was to compare the volume and type of orthopaedic trauma that occurred during the first five months of the COVID-19 pandemic compared to the same time period in prepandemic years.

Methods/Design: As part of the Major Extremity Trauma Research Consortium (METRC), Children’s Mercy has prospectively collected pediatric pelvic and extremity musculoskeletal injuries requiring surgery or hospitalization in the Registry of Orthopaedic Trauma in Children (ROTC) since November 2015. Registry data from Children’s Mercy from April to August in 2020 (COVID) were compared to the same months from 2016-2019 (pre-COVID). The total number of registry entries for those months were used to assess trauma volume and the mechanism of injury for each patient indicated the trauma severity. Statistical analyses were performed using the Student t-test and Mann-Whitney test.

Results: A total of 1770 orthopedic injuries met registry criteria between April and August from 2016 to 2020. The average number of injuries per month from April to August 2020 (COVID) was 77.80 and from April to August 2016-2019 (pre-COVID) was 69.05 (p=0.16). Sport-related injuries (p=0.03) and falls from monkey bars (p=0.02) decreased significantly during COVID-19. Alternatively, injuries caused by ATVs (p=0.0009), dirt bike motorcycles (p=0.02), bicycles (p=0.03), and “other mechanisms” (p=0.002) significantly increased during COVID-19. Motor vehicle occupant injuries also increased, approaching statistical significance (p=0.053).

Conclusions: No decrease in orthopaedic trauma volume was appreciated at our trauma center during the five pandemic months. An overall increase in trauma volume was observed during COVID-19, but it did not reach statistical significance. Lower energy injuries, such as sports-related injuries and falls from monkey bars, decreased during COVID, while higher energy injuries, such as those caused by ATVs, dirt bike motorcycles and motor vehicles, notably increased. More injuries within the “other mechanisms” category suggests that, without organized activities, children and adolescents will find outlets for their energy resulting in exposure to traumatic injury. An unprecedented societal lockdown during the COVID-19 pandemic did not result in a decrease in trauma volume at our Level 1 Midwestern pediatric trauma center, but it did change the nature of the injuries that were treated. This data should be considered when planning future institutional and regional disaster response plans involving the care of children and adolescents.

MeSH Keywords

Trauma, Pediatric Orthopaedics, COVID-19, pandemic

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May 12th, 11:30 AM May 12th, 1:30 PM

The Effect of COVID-19 on Pediatric Orthopaedic Trauma Volume at a Level 1 Pediatric Trauma Center in the Midwestern United States

Background: School and playground closures and the cancellation of extracurricular activities in the Kansas City region on March 17, 2020 due to the COVID-19 pandemic created an unprecedented situation for children and parents. Early reports in the literature on adult and pediatric trauma volume suggested a decrease in orthopaedic injuries during the pandemic. This is the first study to report how the pandemic affected orthopaedic trauma volume at a Level 1 pediatric trauma center during the entire five months since school and activity closures went into effect.

Objectives/Goal: The aim of this study was to compare the volume and type of orthopaedic trauma that occurred during the first five months of the COVID-19 pandemic compared to the same time period in prepandemic years.

Methods/Design: As part of the Major Extremity Trauma Research Consortium (METRC), Children’s Mercy has prospectively collected pediatric pelvic and extremity musculoskeletal injuries requiring surgery or hospitalization in the Registry of Orthopaedic Trauma in Children (ROTC) since November 2015. Registry data from Children’s Mercy from April to August in 2020 (COVID) were compared to the same months from 2016-2019 (pre-COVID). The total number of registry entries for those months were used to assess trauma volume and the mechanism of injury for each patient indicated the trauma severity. Statistical analyses were performed using the Student t-test and Mann-Whitney test.

Results: A total of 1770 orthopedic injuries met registry criteria between April and August from 2016 to 2020. The average number of injuries per month from April to August 2020 (COVID) was 77.80 and from April to August 2016-2019 (pre-COVID) was 69.05 (p=0.16). Sport-related injuries (p=0.03) and falls from monkey bars (p=0.02) decreased significantly during COVID-19. Alternatively, injuries caused by ATVs (p=0.0009), dirt bike motorcycles (p=0.02), bicycles (p=0.03), and “other mechanisms” (p=0.002) significantly increased during COVID-19. Motor vehicle occupant injuries also increased, approaching statistical significance (p=0.053).

Conclusions: No decrease in orthopaedic trauma volume was appreciated at our trauma center during the five pandemic months. An overall increase in trauma volume was observed during COVID-19, but it did not reach statistical significance. Lower energy injuries, such as sports-related injuries and falls from monkey bars, decreased during COVID, while higher energy injuries, such as those caused by ATVs, dirt bike motorcycles and motor vehicles, notably increased. More injuries within the “other mechanisms” category suggests that, without organized activities, children and adolescents will find outlets for their energy resulting in exposure to traumatic injury. An unprecedented societal lockdown during the COVID-19 pandemic did not result in a decrease in trauma volume at our Level 1 Midwestern pediatric trauma center, but it did change the nature of the injuries that were treated. This data should be considered when planning future institutional and regional disaster response plans involving the care of children and adolescents.