Limited Effect of Generalized Systematic Lockdown on Urgent Orthopedic and Limb Trauma Surgery in a Geographical Area Mildly Affected by the First of SARS-CoV-2 Pandemic: A Multicentric Study (Limited Effect of Lockdown in an Area Mildly affected by the Pandemic)

Abstract

Purpose: The SARS-CoV-2 pandemic led to a systematic lockdown of populations in many countries along with the reorganization of care systems to respond to this unprecedented health crisis. This study determined (i) the number of urgent surgical operations carried out during the lockdown in a region of France mildly affected by the SARS-CoV-2 pandemic, and (ii) the types of surgery concerned (main characteristics). Methods: A retrospective, comparative, observational, multicentric study of urgent orthopedic and limb trauma surgery during lockdown was conducted. It included three reference care centers of which two were teaching hospitals. A comparison was made with data for the same period in 2019. For each patient, the following data were collected: date of surgery, age, sex, place of residence, and standardized descriptors used to classify the injury anatomically, context in which the injury occurred, and SARS-CoV-2 PCR status. Results: 1098 patients underwent surgery against 1266 over the same period in 2019, a non-significant difference of −13.3% (p = 0.11) [−39.2% in Week 13 (p = 0.02), +7.6% in Week 19 (p = 0.16)]. Except for bone injuries of the hand and wrist (+13.4%, p = 0.07), a decrease in activity was observed for all anatomic locations, and especially for the distal radius (−55.8%, p = 0.001), ankle (−40.5%, p = 0,01). The context in which the injury occurred changed, with in particular a significant decrease in the number of sport accidents (−80.0%, p < 0.001) and road traffic accidents (−41.8%, p = 0.04), and an increase in DIY and gardening accidents (+62.7%, p < 0.001). Conclusion: The decrease in emergency surgery was much less marked in this geographical area mildly affected by the pandemic. Health policy that sets ways to ensure continuity in the care needed by the population must be adapted locally when a global health crisis strikes. Level of proof: 4 – Descriptive epidemiological study.