The Impact of COVID-19 Lockdown on Hip Fractures in Elderly: A Retrospective Cohort Study

Abstract

The COVID-19 pandemic has caused a substantial burden on health care systems. It has called for extreme measures including lockdown for containment and better allocation of available resources. This study aims to dwell on the effect of this pandemic on the incidence rate of hip fractures in the elderly Lebanese population. A descriptive retrospective study includes hip fracture surgery elderly patients admitted during the COVID-19 lockdown. The time periods studied corresponded to the two months leading up to lockdown (Period A), two months during lock-down (Period B), and the same two-month period in 2019 (Period C). Data collection included patient demographics, injury mechanism, and treatment of choice. There was no significant difference in the rate of hip fractures in the elderly population during the 3 studies periods (p = 0.826). There was no difference in age, gender, type of fracture, or location of the injury. Head trauma and associated fractures were observed to be higher during the lockdown period of the study (p = 0.003 & p = 0.017 respectively). After stratification according to fracture type, Parkinson's disease was higher in the intertrochanteric group during period B (p = 0.036). Head trauma and associated fractures were also confined to the intertrochanteric group favoring period C (p = 0.038). The national lockdown had little effect on fragility hip fractures requiring surgery. Careful understanding of these injuries should allow a more flexible approach and a timely intervention to accommodate for increased morbidity and mortality associated with these injuries.