Introduction

In France, a national lockdown related to the COVID-19 pandemic was imposed from March 17 to May 11, 2020, drastically changing our professional and organizational practices. We were interested on the impact of the lockdown on fragility fractures in older adults (65 years and older). The primary objective of this study was to evaluate the incidence of peripheral and pelvic fragility fractures during the lockdown. The secondary objectives were to carry out an epidemiological analysis of the fractures, treatments and hospitalization data.

Hypothesis

The main hypothesis was that the number of peripheral and pelvic fragility fractures was lower during the lockdown in 2020 than in the same (non-lockdown) period in 2019.

Materials and methods

We retrospectively collected epidemiological (age, sex), clinical (type of fracture, treatment) and hospitalization data from patients 65 years and older who came to the emergency room because of a peripheral and/or pelvic fracture between March 17 and May 11 of the years 2019 and 2020.

Results

We included 192 patients in 2019 and 157 patients in 2020. The mean age and sex ratio were not statistically different. The number of peripheral and/or pelvic fragility fractures decreased by 16%. The share of patients treated surgically was similar in both years (46% in 2019; 51% in 2020 (p = 0.47)). The number of proximal femur fractures dropped by 21%. The mean time to surgery for these fractures was shorter in 2020 (p = 0.02) although the mean length of hospital stay was unchanged (p = 0.72) The mortality rate of patients hospitalized for fragility fractures did not increase significantly (p = 0.51).

Discussion

We observed a reduction in the number of peripheral and pelvic fragility fractures in patients 65 years and older during the lockdown. To ensure that we met our goals of optimal care for proximal femur fractures, a general reorganization of the operating room was necessary. The continued availability of fully functional technical facilities despite this health crisis was crucial to being able to treat these fractures and to prevent increased mortality.

Level of evidence

III, case-control study.

中文翻译：

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COVID 封锁是否改变了老年人脆性骨折的发生率和管理？法国大学医院的病例对照研究

介绍

在法国，从 2020 年 3 月 17 日至 5 月 11 日实施了与 COVID-19 大流行相关的全国封锁，这极大地改变了我们的专业和组织实践。我们对封锁对老年人（65 岁及以上）脆性骨折的影响感兴趣。本研究的主要目的是评估锁定期间外周和骨盆脆性骨折的发生率。次要目标是对骨折、治疗和住院数据进行流行病学分析。

假设

主要假设是 2020 年封锁期间外周和骨盆脆性骨折的数量低于 2019 年同期（非封锁）时期。

材料和方法

我们回顾性收集了 2017 年 3 月 17 日至 5 月 11 日期间因外周和/或骨盆骨折来到急诊室的 65 岁及以上患者的流行病学（年龄、性别）、临床（骨折类型、治疗）和住院数据。 2019 年和 2020 年。

结果

我们在 2019 年纳入了 192 名患者，在 2020 年纳入了 157 名患者。平均年龄和性别比例没有统计学差异。周围和/或骨盆脆性骨折的数量减少了 16%。这两年接受手术治疗的患者比例相似（2019 年为 46%；2020 年为 51%（p  =  0.47））。近端股骨骨折的数量下降了 21%。到 2020 年，这些骨折的平均手术时间缩短了 ( p  =  0.02)，尽管平均住院时间没有变化 ( p  =  0.72)。因脆性骨折住院的患者死亡率没有显着增加 ( p  =  0.51)。

讨论

我们观察到，在封锁期间，65 岁及以上患者的外周和骨盆脆性骨折数量有所减少。为确保我们实现对股骨近端骨折进行最佳护理的目标，有必要对手术室进行全面重组。尽管发生了这场健康危机，但功能齐全的技术设施的持续可用性对于能够治疗这些骨折和防止死亡率增加至关重要。

证据等级

三、病例对照研究。