EPIDEMIOLOGY OF PAEDIATRIC TRAUMA DURING NATIONAL LOCKDOWN: LESSONS FOR THE FUTURE. A RETROSPECTIVE STUDY WITH 12 MONTHS FOLLOW-UP

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Introduction: National lockdown was implemented to slow down the COVID-19 outbreak. This paper aims to compare the epidemiology of paediatric orthopaedic trauma presentation, management and outcomes during the lockdown period with the matched pre-pandemic period in 2019. Methods: This was a retrospective cohort study. All patients aged 0 - 18 years who required trauma unit management during the school closure period (18 March – 25 May 2020) were included. Cases for the matched period in 2019 were analysed for comparison. Patient demographics, mechanism and anatomic location of injury, management, and follow-up were assessed. Results: 286 and 575 injuries were observed in 2020 and 2019, respectively. In 2020, we observed a 50.3% fall in paediatric trauma presentation. There was a significant reduction in the average age at presentation by more than one year (p < 0.001). Sports-related injuries decreased significantly (n=16 5.6% vs n=127 22.1%; p<0.001). Proportion of ride on injuries increased significantly (n=63 22% vs n=61 10.6%; p<0.0001). Non-accidental injury concerns rose significantly (n=9 3.1% vs n=4 0.7%; p=0.01). There was a proportional increase in upper limb injuries (64.3% vs 58.4%) and proportional reduction in lower limb injuries (32.1% vs 35.5%). Use of conservative management increased. Telephone follow-up rose significantly (23% vs 6%; p < 0.001). Re-presentation rate increased significantly (1.4% vs 0.2%; p = 0.04). Conclusion: There was a reduction in paediatric trauma presentation and the average age at presentation during lockdown. This change was accompanied by a shift in mechanism and anatomic location of injury, management, and follow-up.

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