Trauma workload during COVID19 lockdown: an analysis of incidence in 4 million people.

BACKGROUND: Aim of this study is to report the trauma workload during COVID19 lockdown in a region of four million people and to compare it with the same period in 2019. METHODS: The regional register for A&E admissions and hospitalizations has been reviewed in order to compare the number of A&D admission, the triage colour codes rates, aetiology of trauma, number of patients hospitalized for trauma, number of fractures that required surgery, type of fractures and injuries and mean patients' age. RESULTS: During lockdown 7314 patients were admitted in A&E, while 22,508 patients were admitted in 2019. In 2020 and 2019 triage codes were respectively distributed as follows: red code 0.1% vs 0.2%, yellow code 8.9% vs 6.3%, green code 84% vs 84.7% and white code 6% vs 8.8%. (p = 0.042). The number of hospitalized patients for trauma was 670 in 2020, while in 2019 was 1774 (p = 0.02). The most common fracture that required surgery was femur fracture (409 in 2020 vs 635 in 2019); fracture subtype distribution and mean age of the patients were significantly different in the two groups (respectively p < 0.01 and p = 0.02). CONCLUSIONS: One month of lockdown showed a 68% decrease in the number of A&E visits and a 74% decrease of fractures that required surgery. Femur fracture showed the lowest decrease moving from 635 to 409 units but increasing their incidence rate (42 to 61%).

The orthopaedic and traumatology scenario during Covid-19 outbreak in Italy: chronicles of a silent war.

BACKGROUND: From February 21, the day of hospitalisation in ICU of the first diagnosed case of Covid-19, the social situation and the hospitals' organisation throughout Italy dramatically changed. METHODS: The CIO (Club Italiano dell'Osteosintesi) is an Italian society devoted to the study of traumatology that counts members spread in public and private hospitals throughout the country. Fifteen members of the CIO, Chairmen of 15 Orthopaedic and Trauma Units of level 1 or 2 trauma centres in Italy, have been involved in the study. They were asked to record data about surgical, outpatients clinics and ER activity from the 23rd of February to the 4th of April 2020. The data collected were compared with the data of the same timeframe of the previous year (2019). RESULTS: Comparing with last year, overall outpatient activity reduced up to 75%, overall Emergency Room (ER) trauma consultations up to 71%, elective surgical activity reduced up to 100% within two weeks and trauma surgery excluding femoral neck fractures up to 50%. The surgical treatment of femoral neck fractures showed a stable reduction from 15 to 20% without a significant variation during the timeframe. CONCLUSIONS: Covid-19 outbreak showed a tremendous impact on all orthopaedic trauma activities throughout the country except for the surgical treatment of femoral neck fractures, which, although reduced, did not change in percentage within the analysed timeframe.