EPIDEMIOLOGY OF PAEDIATRIC TRAUMA DURING NATIONAL LOCKDOWN: LESSONS FOR
THE FUTURE. A RETROSPECTIVE STUDY WITH 12 MONTHS FOLLOW-UP
Introduction: National lockdown was implemented to slow down the
COVID-19 outbreak. This paper aims to compare the epidemiology of
paediatric orthopaedic trauma presentation, management and outcomes
during the lockdown period with the matched pre-pandemic period in 2019.
Methods: This was a retrospective cohort study. All patients aged 0 - 18
years who required trauma unit management during the school closure
period (18 March – 25 May 2020) were included. Cases for the matched
period in 2019 were analysed for comparison. Patient demographics,
mechanism and anatomic location of injury, management, and follow-up
were assessed. Results: 286 and 575 injuries were observed in 2020 and
2019, respectively. In 2020, we observed a 50.3% fall in paediatric
trauma presentation. There was a significant reduction in the average
age at presentation by more than one year (p < 0.001).
Sports-related injuries decreased significantly (n=16 5.6% vs n=127
22.1%; p<0.001). Proportion of ride on injuries increased
significantly (n=63 22% vs n=61 10.6%; p<0.0001).
Non-accidental injury concerns rose significantly (n=9 3.1% vs n=4
0.7%; p=0.01). There was a proportional increase in upper limb injuries
(64.3% vs 58.4%) and proportional reduction in lower limb injuries
(32.1% vs 35.5%). Use of conservative management increased. Telephone
follow-up rose significantly (23% vs 6%; p < 0.001).
Re-presentation rate increased significantly (1.4% vs 0.2%; p = 0.04).
Conclusion: There was a reduction in paediatric trauma presentation and
the average age at presentation during lockdown. This change was
accompanied by a shift in mechanism and anatomic location of injury,
management, and follow-up.