# The Impact of COVID-19 on Bicycle-Related Injuries Managed at a Level 1 Major Trauma Center in London, United Kingdom

## TL;DR

During the COVID-19 pandemic, more cycling-related injuries were seen at a London trauma center despite overall fewer patients.

## Contribution

The study shows a significant rise in cycling-related orthopedic injuries during the pandemic compared to pre-pandemic levels.

## Key findings

- There was a 35.6% decrease in total orthopedic referrals during the pandemic.
- Cycling-related injuries increased significantly during the pandemic.
- Upper limb trauma was more common in cycling injuries during the pandemic.

## Abstract

Introduction

The COVID-19 pandemic changed peoples' travel behaviors; an uptake in cycling was observed in the United Kingdom. The aim of this study was to assess the cycling-related orthopedic injuries presented to a major trauma center (MTC) before and during the COVID-19 pandemic.

Method

This retrospective observational single-center study analyzed referrals to the orthopedic department during a matched two-month period in 2019 and 2020. Data were collated on cycling-related injuries including demographic variables, mechanism of injury, anatomical area of injury, and the management of injury. The data were compared and statistical analysis was performed using the Pearson Chi-squared test to assess for significance.

Results

A total of 2409 patients were referred to the orthopedic department with injuries. A 35.6% decrease in total referrals was made during the COVID-19 pandemic. Analysis of cycling-specific injuries demonstrated a statistically significant increase in referrals to the orthopedic department during the COVID-19 pandemic. A statistically significant difference in upper limb trauma was also observed during the COVID-19 pandemic. Patterns of management, namely operative vs. non-operative management, did not demonstrate a difference in the two time periods.

Discussion

This study highlights that during the COVID-19 pandemic, cycling behavior changed with more patients suffering orthopedic injuries as a result. Orthopedic departments may need to plan for this change in behaviors with more capacity being created to manage the demand.

Conclusion

Cycling-related injuries referred to the orthopedic department increased during the pandemic.