Impact of the SARS-CoV-2 Outbreak on the Epidemiology and Treatment Outcomes of Fractures of the Proximal Femur in Kazakhstan

The study aimed to assess the impact of isolation and quarantine on the frequency of registration and the treatment of fractures of the proximal femur in Kazakhstan in the context of the COVID-19 pandemic in 2020 (compared to the pre-pandemic period). This retrospective observational comparative study included all primary patients with injuries (the code S72) in the period 2019-2020 according to the national register.

In 2020, the number of S72 fractures was 6.6 % higher compared to 2019. In comparison with 2019, in 2020 the number of beddays of patients was reduced to 7.1±3.8 days (p≤0.001). Both in 2019 and in 2020, the number of women predominated among all patients (p ≤ 0.05). The frequency of conservative treatment in 2020 compared to 2019 was increased from 26.6% to 35.6%, while the surgical procedure for internal fixation was reduced to 34.2% in 2020. In 2020, the highest number of cases among women with S72 fractures cases were recorded in the age groups 60-74 years and 75-90 years. In 2019 in female patients (42%) with S72 cases were registered in the age group 75-90 years.

The incidence of fractures of the proximal femur did not change significantly in 2020 compared to 2019. However, the number of conservative treatment methods has increased along with the decrease in the frequency of surgical interventions. We observed the growth of the frequency of non-surgical treatment methods in 2020 that might impose the possible risks of mortality of these patients in the long term after conservative treatment.