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The impact of COVID-19 national lockdown on orthopaedic trauma admissions in the northern part of South Africa: A multicentre review of tertiary- and secondary-level hospital admissions

P A Rachuene, R R Masipa, R Dey, M Msingapantsi, S M Khanyile, M P Phala, J K Murila, M T Mariba

Abstract


Background. COVID-19 national lockdown measures in South Africa (SA) have been under scrutiny since they were implemented in March 2020. Currently there are no studies showing the effect of the first lockdown on hospital admissions in the northern provinces of SA.

Objectives. To evaluate the impact of national lockdown restrictions on musculoskeletal injury admissions in three hospitals across three provinces (Gauteng, Limpopo and North West).

Methods. In a retrospective review, we compared orthopaedic trauma admissions from 1 April 2020 to 30 June 2020 (during alert level 5 of the national lockdown) with cases admitted during the same period in 2019 (non-lockdown). We reviewed the number of admissions, demographic data and mechanisms of injury in the adult and paediatric population groups.

Results. A total of 449 patients were admitted with musculoskeletal injuries during the lockdown period compared with 664 patients in 2019, equating to a 32% reduction in total admissions. While there was an 8% increase in paediatric admissions during lockdown at Dr George Mukhari Academic Hospital, adult admissions decreased in all centres. More young males were admitted during both lockdown (mean age 39.8 years) and non-lockdown (mean age 41.2 years) periods than females (p=0.004). There were significant reductions in the number of injuries due to motor vehicle accidents (59%) and in the number of gunshot wounds (36%) during lockdown. However, we observed an 11% rise in injuries related to suicide attempts among adult admissions during the lockdown period.

Conclusions. Lockdown restrictions resulted in a significant reduction in orthopaedic trauma admissions, and were effective in terms of allowing institutions to direct resources to the management of COVID-19 patients. In the light of the increased suicide attempts observed during lockdown, future lockdown regulations should include comprehensive measures to relieve socioeconomic stress.


Authors' affiliations

P A Rachuene, Department of Orthopaedic Surgery, Dr George Mukhari Academic Hospital and School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa

R R Masipa, Department of Orthopaedic Surgery, Pietersburg Provincial Hospital, Polokwane, South Africa

R Dey, Division of Orthopaedic Surgery, Department of Surgery, Groote Schuur Hospital, Cape Town, South Africa; Department of Human Biology, Division of Biomedical Engineering, Faculty of Health Sciences, University of Cape Town, South Africa

M Msingapantsi, Department of Orthopaedic Surgery, Job Shimankana Tabane Hospital, Rustenburg, South Africa; Department of Orthopaedics, School of Medicine, Sefako Makgatho Health Sciences University, Satellite Campus, Rustenburg, South Africa

S M Khanyile, Department of Orthopaedic Surgery, Dr George Mukhari Academic Hospital and School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa

M P Phala, Department of Orthopaedic Surgery, Dr George Mukhari Academic Hospital and School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa

J K Murila, Department of Orthopaedic Surgery, Job Shimankana Tabane Hospital, Rustenburg, South Africa; Department of Orthopaedics, School of Medicine, Sefako Makgatho Health Sciences University, Satellite Campus, Rustenburg, South Africa

M T Mariba, Department of Orthopaedic Surgery, Dr George Mukhari Academic Hospital and School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa

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Keywords

COVID-19; Musculoskeletal injuries; Trauma admissions; Orthopaedic injuries

Cite this article

South African Medical Journal 2021;111(7):668-673. DOI:10.7196/SAMJ.2021.v111i7.15581

Article History

Date submitted: 2021-06-30
Date published: 2021-06-30

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