Does the Covid-19 pandemic affect ankle fracture incidence? Moderate decrease in Sweden

Area of Science:

• Orthopedics
• Public Health
• Epidemiology

Background:

• Sweden adopted a restrained approach during the Covid-19 pandemic, emphasizing individual responsibility over strict regulations.
• Previous studies reported significant decreases in fracture incidence during strict lockdowns elsewhere.

Purpose of the Study:

• To investigate changes in ankle fracture incidence in Sweden during the initial phase of the Covid-19 pandemic (March 15 - June 15, 2020).
• To compare fracture rates in 2020 with the preceding three years (2017-2019).

Main Methods:

• Data on ankle fractures were retrieved from the Swedish Fracture Register for 7 selected hospitals.
• Fracture numbers were compared between March 15-June 15, 2020, and the same period in 2017-2019.
• Subgroup analyses included age and sex.

Main Results:

• A 14% reduction in the monthly ankle fracture rate was observed in 2020 compared to the 2017-2019 average.
• Women experienced a 16% decrease, and patients over 70 years old saw a 29% decrease.
• The most significant fracture reduction (26%) occurred during the first 30 days of the study period.

Conclusions:

• A moderate decline in ankle fractures occurred in Sweden during the first Covid-19 wave.
• The greatest reductions were noted in women and individuals over 70, suggesting higher adherence to social distancing recommendations in these groups.
• Changes in ankle fracture incidence may serve as an indicator of the extent of public adherence to health guidelines.