The "COVID-19 Approach" to Distal Radius Fracture Management

Background  In response to the coronavirus pandemic the British Orthopaedic Association Standards for Trauma and Orthopaedics (BOAST) guidelines advised treating distal radius fractures (DRFs) non-operatively where possible. Questions/Purpose  The aim of this study was to assess whether the coronavirus disease 2019 (COVID-19) pandemic lockdown within the United Kingdom did alter the management of DRFs and whether there was any subsequent change in patient outcome or complication rate. Patients and Methods  A retrospective cohort study was performed at a single orthopaedic center within the United Kingdom. The cohort of patients presenting with DRFs during the first lockdown was identified through the virtual fracture clinic database. The cohort of patients from the previous year was also identified for comparison. Data was collected on patient demographics, radiological features of the fractures, management, patient outcome and subsequent complications. Comparisons were then made between the cohorts for each year. Results  The pre-COVID cohort had a significantly higher number of patients reviewed in face-to-face clinic appointments ( p  = 0.0044) and the mean number of clinic appointments for those patients was significantly higher ( p  = 0.0149). There was no significant difference between the cohorts regarding patient complications or any need for return to theater with a minimum 10 month follow-up period. Conclusion  Despite comparative numbers and patterns of DRFs as well as no significant difference in the number of injuries requiring orthopaedic intervention, the burden on fracture clinic services was significantly reduced during the COVID pandemic. Encouragingly, this reduction in follow-up has not translated into an increased prevalence of complications or requirement for further surgery. Level of Evidence  The level of evidence of the study is level III.