Background: This study examined the effect of the COVID-19 pandemic and the resulting decrease in the incidence of various categories of injuries, with the main focus on fractures and mild traumatic brain injuries in a paediatric population. Methods: This retrospective cohort study evaluated all children from 0 to 18 years of age presenting with an injury at the level 1 trauma centre of the University Clinic of Orthopaedics and Trauma Surgery in Vienna during the lockdown from 16 March to 29 May 2020 compared to records over the same timeframe from 2015 to 2019. Results: In total, 14,707 patients with injuries were included. The lockdown did not lead to a significant decrease in fractures but, instead, yielded a highly significant increase in mild traumatic brain injuries when compared to all injuries that occurred (p = 0.082 and p = 0.0001) as well as acute injuries (excluding contusions, distortions and miscellaneous non-acute injuries) (p = 0.309 and p = 0.034). Conclusions: The percentage of paediatric fractures did not decrease at the level 1 trauma centre, and a highly significant proportional increase in paediatric patients with mild traumatic brain injuries was observed during the COVID-19 lockdown. Therefore, medical resources should be maintained to treat paediatric trauma patients and provide neurological monitoring during pandemic lockdowns.

The aim of this study was to present the frequencies and characteristics of paediatric spine fractures, focusing on injury mechanisms, diagnostics, management, and outcomes. This retrospective, epidemiological study evaluated all patients aged 0 to 18 years with spine fractures that were treated at a level 1 trauma centre between January 2002 and December 2019. The study population included 144 patients (mean age 14.5 ± 3.7 years; 40.3% female and 59.7% male), with a total of 269 fractures. Common injury mechanisms included fall from height injuries (45.8%), with an increasing prevalence of sport incidents (29.9%) and a decreasing prevalence of road incidents (20.8%). The most common localisation was the thoracic spine (43.1%), followed by the lumbar spine (38.2%), and the cervical spine (11.8%). Initially, 5.6% of patients had neurological deficits, which remained postoperatively in 4.2% of patients. Most (75.0%) of the patients were treated conservatively, although 25.0% were treated surgically. A small proportion, 3.5%, of patients presented postoperative complications. The present study emphasises the rarity of spinal fractures in children and adolescents and shows that cervical spine fractures are more frequent in older children, occurring with a higher rate in sport incidents. Over the last few years, a decrease in road incidents and an increase in sport incidents in paediatric spine fractures has been observed.

The COVID-19 pandemic and the resulting restrictions led to a reduced number of surgeries. This study examines its impact on the course of treatment and clinical outcome of surgically treated paediatric upper limb fractures during that specific period. This retrospective cohort study evaluated all children aged 0–18 years presenting with an upper limb fracture treated surgically at the level 1 trauma centre of the University Clinic of Orthopaedics and Trauma Surgery of Vienna within lockdown from 16 March to 29 May 2020 (definition applied through corresponding legislation) compared to the same period from 2015 to 2019. A total number of 127 children (m:63; f:44) were included. The lockdown did not lead to a significant increase in complications during and after initial surgery. Time until removal of implant was not significantly prolonged (p = 0.068; p = 0.46). The clinical outcome did not significantly differ compared to previous years. The experience of a level 1 trauma centre showed that despite reduced surgical capacity during the COVID-19 pandemic, no negative differences concerning course of treatment and clinical outcome of surgically treated paediatric upper limb fractures were present. These findings are still of importance since the COVID-19 pandemic continues and several countries in Central Europe are currently under their fourth lockdown.