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The coronavirus disease clavicle study: a predictor of future trauma trends
Ghazal Hodhody1, Joann W Y Lum1, Sadia Afzal1
1Royal Bolton Hospital, Bolton, UK.
Insights
The COVID-19 pandemic led to fewer overall clavicle fractures but a threefold increase in cycling-related injuries. This trend, driven by behavioral changes, predicts future trauma patterns.
Area of Science:
- Orthopedics
- Trauma Surgery
- Epidemiology
Background:
- Clavicle fractures are common emergency presentations, often resulting from falls and sports injuries.
- The COVID-19 pandemic and associated social isolation altered behavior patterns, impacting fracture presentations.
- This study investigated the pandemic's effects on clavicle fracture mechanisms and management.
Purpose of the Study:
- To analyze changes in clavicle fracture incidence and mechanisms during the COVID-19 pandemic.
- To compare fracture data from the pandemic period with the preceding year.
- To assess the implications of observed trends for future trauma management.
Main Methods:
- A longitudinal observational study was conducted across 10 hospitals in North West England.
- Data on clavicle fractures were collected during a 6-week period in the first COVID-19 peak and compared to the same period in 2019.
- Patient demographics, fracture characteristics, injury mechanisms, and management strategies were reviewed.
Main Results:
- A total of 427 clavicle fractures were analyzed, with fewer presentations in 2020 (n=177) versus 2019 (n=250).
- Cycling-related fractures increased threefold during the pandemic.
- Higher energy trauma fractures rose, and time to surgery decreased by an average of 2.7 days in the COVID cohort.
Conclusions:
- Increased cycling due to pandemic-related behavioral changes significantly elevated clavicle fracture incidence.
- This rise in cycling trauma is a predictor of future injury trends, especially with UK government's cycling promotion.
- The findings highlight the need to adapt trauma care strategies to evolving public behavior and activity patterns.
Background:
Clavicle fractures are a common presentation to the emergency department after falls and sporting injuries. During 2020, the coronavirus disease 2019 (COVID-19) pandemic brought with it a long period of social isolation, resulting in a change of behavior patterns and, in return, the presentation of fractures to our local hospitals. The effects of this global pandemic on the presentation and management of clavicles were noted with particular interest to the change in mechanism and its future implications.
Methods:
We performed a longitudinal observational study in 10 hospitals in the North West of England, reviewing all patients presenting with a clavicle fracture during 6 weeks in the first peak of COVID-19 pandemic and compared these with the same period in 2019. Collection points included the patient demographics, fracture characteristics, mechanism of injury, and management.
Results:
A total of 427 clavicle fractures were assessed with lower numbers of patients presenting with a clavicle fracture during the COVID-2020 period (n = 177) compared with 2019 (n = 250). Cycling-related clavicle fractures increased 3-fold during the pandemic compared with the 2019 control group. We also noted an overall increase in clavicle fractures resulting from higher energy trauma as opposed to low energy or fragility fracture. We also found a faster time to surgery in the COVID cohort by 2.7 days on average when compared with 2019.
Conclusions:
Government restrictions and the encouragement of social distancing led to behavioral changes with a vast increase in cyclists on the road. This created a significant rise in clavicle fractures related to this activity. This is likely to be further driven by the government pledge to double cyclists on the road by 2025 in the United Kingdom. We forecast that this increase in cyclists, a behavior change accelerated by the pandemic, is a reliable predictor for future trauma trends.
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