Trends and patterns in hand injuries during the a pandemic.

PURPOSE: A significant portion of the musculoskeletal extremity injuries are hand and finger injuries. Strict government measures during the COVID-19 pandemic led to changes in incidence, types and mechanisms of hand injuries. Data is needed to develop targeted strategies for management and treatment of these injuries effectively in case of future pandemics. METHODS: In this retrospective study, data were gathered during calendar weeks 11-18 in the years 2019 (pre-pandemic) and 2020 (pandemic). Patients were categorized into adults and children (<18 years). Type of hand injury was further categorized into: carpal injuries or dislocations, metacarpal injuries or dislocations, phalangeal fractures, finger dislocations and mallet fingers. RESULTS: During the pandemic the absolute number of hand injuries decreased by 55%, the decrease was larger in children (73%) then in adults (48%). In children, sports as underlying trauma mechanism decreased from 50% to 16%, metacarpal injuries due to physical interactions doubled proportionally from 33% to 70%. In adults, hand injuries caused by sports decreased while injuries resulting from physical interactions increased from 9% to 20%, more patients were operated on (13% versus 7%; p = 0.018). Metacarpal injuries proportionally increased and experienced a higher operation rate (20% versus 7%; p = 0.026), mallet patients were more often female (50% versus 13%; p = 0.031). CONCLUSIONS: Restrictions during a pandemic lead to an absolute decrease in number of patients with hand and finger injuries, cause a shift in underlying trauma mechanisms from sport to physical interactions, result in a significantly higher probability of needing operative treatment when being an adult patient. LEVEL OF EVIDENCE: IV.