ABSTRACT
Purpose of Study The COVID-19 pandemic required rapid, global healthcare shifts to prioritize urgent or pandemic-related care and minimize transmission. Little is known about impacts on pediatric orthopedic surgeons during this time. We aimed to investigate COVID-19 related changes in practice, training, and research among pediatric orthopedic surgeons globally. Methods Used An online, cross-sectional survey was administered to orthopedic surgeons with interest in pediatrics in April 2020. The survey captured demographics and selfreported experiences during the pandemic. Surgeons were recruited through web media and email lists of orthopaedic societies over 2 months. Descriptive statistics were used to analyze results. Summary of Results We received 460 responses from 45 countries. 358 (78.5%) respondents reported lockdown measures in their region at time of survey. Most (n=337, 94.4%) reported pausing all elective procedures. Surgeons reported reduction in average number of surgeries per week, from 6.89 (SD=4.61) pre-pandemic to 1.25 (SD=2.26) at time of survey (mean difference= 5.64;95% CI=5.19, 6.10). Average number of elective outpatient appointments per week decreased from 67.89 (SD=45.78) pre-pandemic to 11.79 (SD=15.83) at time of survey (mean difference=56.10, 95% CI: 5.61, 60.58). 177 (39.4%) surgeons reported using virtual modes of outpatient appointments for the first time. Of 290 surgeons with trainees, 223 (84.5%) reported systems to continue training. Of 192 surgeons with research, 149 (82.8%) reported continuing research activities during pandemic. Most reported cessation (n=75, 64.1%) or reduction (n=40, 34.1%) in patient recruitment at time of survey. Conclusions We found significant impacts on pediatric orthopaedic practice with uptake of technology to provide care continuity. Understanding global impacts can inform sustainable practices to provide continuity in future disruptions. We will pursue follow-up surveys to assess longitudinal impacts on surgeons. Epidemiological studies are needed to assess impacts of delayed and virtual care on patient outcomes.