The ‘lockdown approach’ to distal radius fractures reduced the burden on outpatient orthopaedic services with no impact on patient outcome

Lucy Walker, David O’Connor, Simon Richards , Jeremy Southgate

University Hospitals Dorset

In response to the coronavirus pandemic the BOAST guidelines advised treating distal radius fractures (DRFs) non-operatively where possible. The objective of this study was to assess whether the COVID pandemic lockdown within the UK altered the management of DRFs and whether there was any subsequent change in patient outcome or complication rate.

A retrospective cohort study was performed at a single orthopaedic centre. Patients presenting with DRFs during the first lockdown was identified through the virtual fracture clinic database. The cohort of patients from the previous year was also identified for comparison. Data was collected on patient demographics, radiological features of the fractures, management, patient outcome and subsequent complications. Comparisons were then made between the cohorts for each year.

The final cohort comprised of 268 fractures in the pre-COVID cohort and 257 fractures in the COVID cohort. There was no significant difference between the two cohorts regarding the number of patients requiring open reduction and internal fixation. The pre-COVID cohort had a significantly higher number of patients reviewed in face-to-face clinic appointments (p=0.004459) and the mean number of clinic appointments for those patients was significantly higher (p=0.014958). There was no significant difference between the cohorts regarding patient complications with a minimum ten month follow-up period.

Despite comparative numbers and patterns of DRFs the burden on fracture clinic services was significantly reduced during the COVID-19 pandemic. This reduction in follow-up has not translated into an increased prevalence of complications nor requirement for further surgery.