# Impact of COVID-19 Pandemic on Hand Surgery Volume in Japan

## TL;DR

The study found that the COVID-19 pandemic initially reduced hand surgery volumes in Japan, but most procedures recovered, with a notable shift to outpatient surgeries.

## Contribution

This study provides new insights into how the pandemic affected hand surgery practices and led to a shift in surgical settings in Japan.

## Key findings

- Scheduled surgeries dropped by 44% during the first pandemic wave, especially for arthroplasties and polydactyly.
- Trauma surgeries remained stable, while some procedures like tendon repair increased during the pandemic.
- Outpatient surgeries increased significantly for wrist and forearm fractures and amputations.

## Abstract

Objectives: The impact of the COVID-19 pandemic on hand surgery in Japan has not been fully elucidated. This study investigated changes in the volume of hand surgery practiced during the pandemic. Methods: We used the National Database Open Data Japan (NDB-ODJ), a comprehensive repository of healthcare data administered by the government, to investigate changes in the volume of hand surgery services delivered during the COVID-19 pandemic. The type and number of upper extremity surgical procedures was examined during each month of the pandemic to identify associations. Results: During the first wave in the spring of 2020, scheduled surgeries decreased by 44% compared to pre-pandemic levels, with arthroplasties, osteotomies, and polydactyly surgeries experiencing the largest reductions. Trauma surgeries remained relatively stable, and some procedures like tendon repair and replantation even increased. While overall surgical volumes recovered in the second half of the pandemic, certain procedures, including finger pinning and tendon repair, remained below pre-pandemic levels. Interestingly, surgeries for Dupuytren contracture and amputation increased compared with the pre-pandemic period. Many scheduled and emergency procedures shifted to outpatient surgeries during the pandemic, and the proportion of inpatient surgeries decreased. In particular, the proportion of outpatient surgeries increased significantly in open reduction and internal fixation for wrist and forearm fractures, as well as in amputation surgeries. Conclusions: The COVID-19 pandemic had a minimal impact on the volume of hand surgery conducted in Japan, with a decrease in elective surgeries only during the first wave in the spring of 2020. Notably, the pandemic triggered a shift from inpatient to outpatient surgery for many procedures.