TO EVALUATE LOCKDOWN EFFECTS ON PEDIATRICS ORTHOPEDIC TRAUMA EPIDEMIOLOGY BEFORE, DURING AND AFTER COVID-19 PANDEMIC IN A TERTIARY HOSPITAL- AN OBSERVATIONAL STUDY

ABSTRACT

Background: Corona pandemic and its resultant lockdown have caused a devastated effect of life of human beings. We conducted this study during Covid-19 period to analyze the effects of lockdown on pediatric trauma variations in injury pattern and its severity among children in a tertiary hospital. Materials and Methods: Patients of less than 16 year presented to orthopedic trauma were defined in this study. The study has been divided into three time periods. Patients presented from March 2019 to July 2019 (base line period), March 2020 to July 2020 (Lockdown period) and March 2021 to July 2021 (post lockdown period) were identified and compared in this retrospective cross sectional study. The children included in this study were either requiring manipulation under anesthesia or surgical intervention in operation theatre. We conducted unadjusted bivariate analyses of injury patterns during these periods. Segmented linear regression models were used to evaluate the rates of injuries before, during and after pandemic period. The one way analysis of variance (ANOVA) was used to evaluate the differences in means of three independent groups. Results: A total of 231 numbers of children with orthopedic trauma were presented to our tertiary hospital. Out of these, 111 were admitted during pre-pandemic period and 45 in the pandemic period with 75 children during post pandemic period. During lockdown period, mean age of children with significant orthopedic trauma has decreased to 7.5 years in comparison to base line which was about 8.5 years and post lockdown period 9.25 years. Boys outnumbered the girls during this study. The outdoor injury has drastically decreased from 65.75% in base line to 35.65% in lockdown period, but this pattern has increased to 85.25% in post lockdown period. Conclusion: Our study has shown that during lock down in Covid pandemic, there was a decrease of 59.46% cases of pediatric trauma patients in which surgical intervention or manipulation in operation theatre was required. These changes in epidemiology may be due to modified approach followed by surgeon while following strict Covid guidelines. Our study has also mentioned increase in domestic injuries requiring surgical intervention which may be due to lock down implications by national protocols. We recommend to create a safe environment for children during indoor and outdoor activities and creating awareness among parents to safe guard their siblings. All above these measures may reduce the burden on health care facilities.