Ibrahim Yahya, Huq Sumon, Shanmuganathan Kanatheepan, Gille Helen, Buddhdev Pranai
Orthopaedic Department, Broomfield Hospital, Mid Essex Hospital NHS Trust, Chelmsford, UK.
Bone Jt Open. 2021 Feb;2(2):86-92. doi: 10.1302/2633-1462.22.BJO-2020-0152.R1.
This observational study examines the effect of the COVID-19 pandemic upon the paediatric trauma burden of a district general hospital. We aim to compare the nature and volume of the paediatric trauma during the first 2020 UK lockdown period with the same period in 2019.
Prospective data was collected from 23 March 2020 to 14 June 2020 and compared with retrospective data collected from 23 March 2019 to 14 June 2019. Patient demographics, mechanism of injury, nature of the injury, and details of any surgery were tabulated and statistically analyzed using the independent-samples -test for normally distributed data and the Mann-Whitney-U test for non-parametric data. Additionally, patients were contacted by telephone to further explore the mechanism of injury where required, to gain some qualitative insight into the risk factors for injury.
The 2020 lockdown resulted in 30% fewer paediatric trauma presentations (441 vs 306), but no significant change in the number of patients requiring surgery (47 vs 51; p = 0.686). Trampolining injuries increased in absolute numbers by 168% (p < 0.001), almost four times more common when considered as percentage of all injuries observed in 2020 vs 2019. There was a decrease in high energy trauma from road traffic accidents and falls from height (21.5% decrease, p < 0.001). Despite a shift towards more conservative treatment options, trampolining injuries continued to require surgery in similar proportions (19.4 vs 20%; p = 0.708). Qualitative investigation revealed that the most common risk factor for trampolining injury was concurrent usage, especially with an older child.
COVID-19 lockdown has resulted in a decrease in paediatric orthopaedic presentations and high energy trauma. However, due to a marked increase in home trampolining injuries, and their unchanged requirement for surgery, there has been no change in the requirement for surgery during the lockdown period. As home exercise becomes more prevalent, a duty of public health falls upon clinicians to advise parents against trampoline usage. Cite this article: 2021;2(2):86-92.
本观察性研究探讨了新冠疫情对一家地区综合医院小儿创伤负担的影响。我们旨在比较2020年英国首次封锁期间与2019年同期小儿创伤的性质和数量。
前瞻性数据收集于2020年3月23日至2020年6月14日，并与2019年3月23日至2019年6月14日收集的回顾性数据进行比较。将患者的人口统计学资料、受伤机制、损伤性质以及任何手术的详细情况制成表格，并使用独立样本t检验对正态分布数据进行统计分析，使用曼-惠特尼U检验对非参数数据进行统计分析。此外，必要时通过电话联系患者，进一步探究受伤机制，以对损伤的危险因素获得一些定性认识。
2020年的封锁导致小儿创伤就诊人数减少了30%（441例对306例），但需要手术的患者数量没有显著变化（47例对51例；p = 0.686）。蹦床受伤的绝对数量增加了168%（p < 0.001），与2019年相比，在2020年观察到的所有损伤中所占百分比时，其常见程度几乎增加了四倍。道路交通事故和高处坠落导致的高能创伤有所减少（减少21.5%，p < 0.001）。尽管治疗选择趋向于更保守，但蹦床受伤仍有相似比例的患者需要手术（19.4%对20%；p = 0.708）。定性调查显示，蹦床受伤最常见的危险因素是同时使用，尤其是与年龄较大的儿童一起使用。
新冠疫情封锁导致小儿骨科就诊人数和高能创伤减少。然而，由于家庭蹦床受伤显著增加，且其手术需求未变，封锁期间手术需求没有变化。随着家庭锻炼变得更加普遍，临床医生有责任向家长建议不要使用蹦床，以履行公共卫生职责。引用本文：2021；2(2):86 - 92。
