Effect of COVID-19 on orthopedic injuries due to assault

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ABSTRACT: INTRODUCTION This study aims to determine changes in the rates of orthopedic injuries due to assault before, during, and after the COVID-19 pandemic. METHODS The National Electronic Injury Surveillance System (NEISS) hospital survey publicly available data was queried from 2000–2021, and summarized by fracture status, assault status, time-period relative to the COVID-19 pandemic (before: before 02/28/2020; during: 03/01/2020-02/28/2021; and after: 03/01/2021-onwards), and overall injury status. Pearson’s chi-squared test and Fisher’s exact test were used to assess categorical differences. A logistic regression model was applied to calculate odds ratios with 95% confidence intervals. All analyses and data visualizations were conducted using R. RESULTS Females had increased fracture risk (39% before, 47% during, 46% after; p <0.001). Fracture increased in Hispanic (7.7% before, 11% during, 11% after) and Black patients (14% before, 17% during, 19% after; p <0.001). Fractures increased most in those 55-64 years old (8.6% vs. 11%) and 65-74 years old (6.8% vs. 10%; p value <0.001) before vs. during COVID. Mechanism of injury attributable to assault increased (5.8% before, 6.9% during, and 6.5% after COVID; p <0.001). Rates of assault perpetrated by a spouse/partner increased (6.8% before, 8.4% during, 7.0% after COVID). Injuries attributable to assault were highest in 2020 at 6.91%. Fractures attributable to assault were highest in 2021 at 15.28%. Female and Black patients were at increased risk for fractures related to assault both during and after COVID. Assaults in school decreased during COVID (5.0%-0.6%). Assault related fracture increased most in patients aged 55-64 (4.8% vs. 8.4%) and decreased most in patients aged 10-14 (7.1%-1.7%). CONCLUSION Our findings show that women, elderly, Hispanic, and Black patients were among the demographics most at risk for fractures during the COVID-19 period and represent a population that should be targeted for screening in the setting of orthopedic fracture clinic.

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