Expect postoperative care disruptions for orthopaedic trauma patients during the COVID-19 pandemic: a retrospective review of patient care trends

Background: With the global COVID-19 pandemic arriving in New York City (NYC) public health measures were instituted to prevent disease spread. Orthopaedic trauma continued despite the pandemic, and patients were left attempting to obtain postoperative care while the city's focus shifted to the pandemic. The purpose of this study was to evaluate postoperative care of patients treated for orthopaedic trauma during the COVID-19 pandemic in NYC and identify areas for improvement in the event of an expected second wave. Methods: All patients who received operative care for orthopaedic trauma during the pandemic time period by two fellowship-trained orthopaedic traumatologists were identified, and their records were reviewed. Results: Forty-nine patients were included for analysis. Six patients (12%) tested positive for COVID-19. Six of 24 patients (25%) who were recommended to be discharged to inpatient rehabilitation refused. Of the 31 patients discharged home, nine patients (29%) refused in-home services. Thirteen of 31 patients (42%) reported a delay in receiving outpatient physical therapy, and five patients (16%) reported difficulty filling prescriptions. There were 1,814 scheduled visits in the orthopaedic trauma clinic from March to May 2019 with 1,126 attended visits (62%). During the pandemic there were 295 scheduled visits with 175 attended visits (59%, P=0.367). At the peak of the pandemic in April 2020 there were 58 scheduled visits with 27 attended visits (47%, P=0.017). Conclusions: Patients treated for orthopaedic trauma during the COVID-19 pandemic were at increased risk of improper discharge, delay in outpatient services, and absent follow-up, which may together pose an increased risk of adverse events.