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Short-term effects of COVID-19 on the risk of traumatic fractures in China cities
Hongzhi Lv1, Xiaolin Zhang2, Juan Wang1
1Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China.
Insights
The study found that during the COVID-19 pandemic, fracture risk decreased in most populations, including children and elderly men, with increased cases. Home prevention measures are key for reducing traumatic fractures.
Area of Science:
- Epidemiology
- Public Health
- Traumatology
Background:
- The COVID-19 pandemic has impacted global health and daily life.
- Understanding its effect on non-COVID-19 health outcomes, like traumatic fractures, is crucial.
Purpose of the Study:
- To investigate the association between COVID-19 prevalence and traumatic fracture risk in China.
- To provide data-driven insights for fracture prevention strategies worldwide.
Main Methods:
- Retrospective analysis of a nationally representative sample of COVID-19 prevalence areas in China.
- Data collection on traumatic fracture patients (Jan-Jul 2020) including demographics, fracture site, and injury mechanism.
- Descriptive epidemiology and a distributed lag nonlinear model to explore associations.
Main Results:
- A total of 67,249 patients with 68,989 fractures were analyzed.
- Tibia/fibula fractures were most common (14.9%), followed by femur (13.6%). Low-energy fractures comprised 23.3%.
- Increased COVID-19 cases correlated with decreased fracture risk in most groups, except elderly women, and particularly for low-energy fractures in high-prevalence areas.
Conclusions:
- The COVID-19 pandemic was associated with a significant reduction in traumatic fracture risk across various demographics and fracture types.
- Home-based prevention measures are highlighted as essential for mitigating traumatic fracture incidence.
Abstract:
This study aimed to investigate the association between COVID-19 and fracture risk and provide a targeted reference for the world through China's experience. A nationally representative sample of COVID-19 prevalence areas selected using stratified random sampling was retrospectively analyzed. Age, sex, fracture site, mechanism of injury, and concurrent fractures of traumatic fracture patients in selected hospitals were collected from 10 January to 10 July 2020. The epidemiologic characteristics of traumatic fractures and the association between COVID-19 and fracture risk were explored using descriptive epidemiological methods and a distributed lag nonlinear model. A total of 67,249 patients (52.3% males, 49.4 ± 19.4 years old) with 68,989 fractures were included. The highest proportion of fractures were in the tibia and fibula (14.9%), followed by the femur (13.6%) and ulna and radius (12.5%). Low-energy fractures accounted for 23.3%. With the increase in newly confirmed COVID-19 cases, fracture risk decreased for children, young and middle-aged adults, elderly men, high-energy fractures, and residents in regions with < 1000 cumulative confirmed COVID-19 cases. Fracture risk decreased sharply in all residents except elderly women, for low-energy fractures, and in regions with > 1000 cumulative confirmed COVID-19 cases when newly confirmed COVID-19 cases increased in China. Primary (home) prevention measures are emphasized to prevent traumatic fractures.
