• S Gumina, R Proietti, C Villani, S Carbone, and V Candela.
• Dept. of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome; Istituto Clinico Ortopedico Traumatologico (ICOT), Latina, Italy.
• JSES Int. 2020 Sep 21.

BackgroundAim of this study was to evaluate the impact of COVID-19 on the shoulder and elbow trauma in a skeletally immature population in 30 days starting from the March 8 2020, the first day of restrictions in Italy, and to compare it with the same days of 2019.Materials And MethodsAll the skeletally immature (younger than 18 ys) patients managed in the Emergency Unit of our Hospital between March 8 2020 and 8thApril 2020 (COVID-19 period, C19) for a shoulder and elbow trauma were retrospectively included and compared to patients with similar ages admitted in the same period of 2019 (no COVID-19 period, NC19). Six categories of diagnosis were distinguished: 1) contusions, 2) no physeal fractures, 3) physeal fractures (Salter-Harris), 4) sprains/subluxations,5) dislocations, 6) others (tendinitis, wounds, low back pain, joint inflammation). According to the mechanism of injury we arbitrarily distinguished 6 subgroups: a) Accidental fall;b) Sport trauma; c) Accident at school; d) High energy trauma occurred by car, public transport, pedestrian investment; e) Fall from high.ResultsDuring the C19 period, the number of total accesses in our Trauma Center steeply decreased: two thirds less. Regardless of the patient age, we performed 65% less first aid shoulder/elbow services. Skeletally immature patients treated at our Trauma Center for all types of injury during the NC19 period were 350 and 54 during the C19 period; therefore, the influx of pediatric patients during the C19 period decreased by 84.6%. Furthermore: a) in the C19 period there were no cases of fractures, physeal fractures and dislocations of the shoulder; b) in the C19 period we had no cases of contusion, physeal fractures, and dislocations of the elbow; c) during the C19 period we observed the absence of high-energy, sports and school injuries; d) during the pandemic, shoulder and elbow injuries mainly occurred as a result of accidental fall at home.ConclusionsThe pandemic forced us to become aware of the ways and places where skeletally immature subjects report shoulder and elbow traumas; therefore, it would be desirable that more considerable attention be directed towards the prevention of injury in areas at risk.© 2020 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.

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