Abstract
BackgroundThe World Health Organization classified Covid-19 as a pandemic during the first months of 2020 as lockdown measures were implemented globally to mitigate the increasing incidence of Covid-19-related morbidity and mortality. The purpose of this study was to evaluate the effect of national lockdown measures on proximal femur fracture epidemiology. Our hypothesis was that due to the prolonged period of stay-at-home orders, we would observe a decrease in the incidence of proximal femur fractures during the years 2020–21.MethodsA retrospective case–control study of 2784 hip fractures admitted to the emergency department at one hospital between January 1, 2010, and March 31, 2021, was conducted. Cases were stratified weekly, and an analysis was conducted comparing cases occurring during government-imposed lockdown periods of 2020–21 to corresponding periods during 2010–2019. Furthermore, the trend of cases throughout the year of 2020 was observed.ResultsOf all proximal femur fracture cases included, 2522 occurred between 2010–2019 and 261 during the Covid-19 period. There was no significant difference in age (81.95 vs. 82.09; P = 0.78) or gender (P = 0.12). There was a total decrease of 21.64% in proximal femur fracture per week during the entirety of the Covid-19 pandemic period compared to the previous years (3.64 ± 1.99 vs. 4.76 ± 0.83; P = 0.001). During all three lockdown periods, there was a significant decrease in proximal femur fracture cases per week (3.55 ± 2.60 vs. 4.87 ± 0.95; P = 0.04), and the most pronounced decrease occurred during the third lockdown period (2.89 ± 1.96 vs. 5.23 ± 1.18; P = 0.01).ConclusionWe observed a total decrease in the number of proximal femur fractures occurring during the Covid-19 era compared to previous years and specifically a decrease of cases occurring during the government-imposed lockdown periods. The decrease in cases was more pronounced during the second and third lockdown periods.
Highlights
The Covid-19 pandemic was caused by the Coronavirus-2 of Severe Acute Respiratory Syndrome (SARSCoV-2)
We observed a total decrease in the number of proximal femur fractures occurring during the Covid-19 era compared to previous years and a decrease of cases occurring during the government-imposed lockdown periods
During the study period, 2784 patients presented with proximal femur fractures and met inclusion and exclusion criteria
Summary
The Covid-19 pandemic was caused by the Coronavirus-2 of Severe Acute Respiratory Syndrome (SARSCoV-2). First reported in December 2019 in Wuhan, China, the virus rapidly spread worldwide until the World Health Organization (WHO) declared a pandemic on January 30, 2020 [1, 2]. The Israeli Ministry of Health (MOH) put into effect steps to mitigate the spread of the virus. The initial lockdown measures were successful in drastically reducing Covid-19 cases. On December 25, 2020 Israel initiated a national program for vaccination of the elderly population as well as healthcare workers, which succeeded in drastically lowering cases of Covid-19 [8]. The World Health Organization classified Covid-19 as a pandemic during the first months of 2020 as lockdown measures were implemented globally to mitigate the increasing incidence of Covid-19-related morbidity and mortality. Our hypothesis was that due to the prolonged period of stay-at-home orders, we would observe a decrease in the incidence of proximal femur fractures during the years 2020–21
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