%0 Journal Article %T The Relationship of the COVID-19 pandemic with the Incidence and Management of Upper Limb Fractures: Double-Centre Study %J The Archives of Bone and Joint Surgery %I Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association %Z 2345-4644 %A Springthorpe, Thomas %A Pearce, Matthew %A Nowicka, Maria %A Niazi, Noman %A Pillai, Anand %D 2022 %\ 10/01/2022 %V 10 %N 10 %P 871-876 %! The Relationship of the COVID-19 pandemic with the Incidence and Management of Upper Limb Fractures: Double-Centre Study %K COVID-19 %K Coronavirus %K Upper limb trauma %R 10.22038/abjs.2022.59285.2929 %X Background: The COVID-19 pandemic brought about the placement of severe social restrictions in the UnitedKingdom, limiting activity and impacting public behavior. Limited studies have been published on the relationship ofthe coronavirus pandemic with the presentation and management of upper limb fractures. The aims of this studywere first to assess the change in the incidence of upper limb fractures at key points during the COVID-19 pandemicsuch as the enactment and lifting of lockdowns, and second to evaluate the relationship between local COVID-19burden and measures of service efficiency across our trust.Methods: We undertook a retrospective analysis of all upper limb fracture referrals, admissions, and surgical proceduresfrom the 1st of March 2020 to the 28th of February 2021. Changes in upper limb fracture incidence were mapped tosignificant changes in social restrictions. Measurements of service efficiency including time from admission to theatreand length of stay for admitted upper limb fracture patients were mapped to local COVID-19 burden. Subgroup analysiswas undertaken to compare across age groups, including the pediatric population, all adults, and the elderly.Results: The study involved 1251, 659, and 641 patients with upper limb fracture referrals, admissions, and proceduresacross the trust, respectively. Referrals (n=128) and procedures (n=72) both peaked in August 2020. Admissions peakedin both May and December 2020 (63 for both). Admissions and procedures both demonstrated a decrease in March andApril 2020 compared to the rest of the study period (40 and 38 admissions, as well as 48 and 29 procedures respectively).Across the cohort, referrals and admissions did not demonstrate a statistically significant relationship with the relaxing ofsocial restrictions (P=0.504). There were statistically significant differences among referrals, admissions, and procedureswhen stratifying patients by age (P=<0.001). Length of stay demonstrated an inverse relationship with COVID-19 burdenthroughout the study period, with the shortest average length of stay recorded in months with the highest number of localCOVID-19 cases. The average time from injury occurrence to theatre increased during the winter months (P=0.001).Conclusion: There is a relationship between changes in social restrictions and the incidence of upper limb fractures.These changes also had differing impacts on upper limb fracture rates when stratifying by patient age groups. Theorthopedic service demonstrated adaptability in response to the local COVID-19 burden, and further research isneeded to determine what effect this had on clinical outcomes.Level of evidence: IV %U https://abjs.mums.ac.ir/article_20974_69a96ffe8918f7063d71a5c4b8478983.pdf