Okike K, Chan PH, Navarro RA, et al. - At the beginning of the COVID-19 pandemic in March-April 2020, studies described a decline in orthopedic trauma (ie, fractures) in the general population, this was followed by a return to baseline by summer 2020 once shelter-in-place orders were lifted. Researchers aimed at determining the hip fracture surgery volumes among individuals 65 years or older during the pandemic.

• Among older individuals, hip fractures are common (> 250,000 per year in the US) and consequential (1-year mortality rate, 12%-37%).

• Using data from the Kaiser Permanente (KP) Hip Fracture Registry (a surveillance tool with 100% coverage) along with membership data and administrative claims, researchers retrieved data of 18,288 patients (mean age, 82 years; 70.0% female; 7.9% Asian, 5.1% Black, 12.4% Hispanic, 0.7% Native American, 74.0% White; 83% with ≥ 3 comorbidities) who underwent hip fracture surgery between January 1, 2018, and September 26, 2021, in a California KP hospital (n = 31).

• Except for fall 2020 when COVID-19 cases were low, there were lower hip fracture surgery volumes among older individuals when compared with 2 years previously starting with the spring 2020 surge until the COVID-19 vaccine became widely available in spring 2021.

• In contrast, the general population had fracture incidence returned to baseline once shelter-in-place orders were lifted.

• For the lower hip fracture surgery volumes among older individuals during the pandemic, a possible explanation is the reduced activity outside the home.

• Consideration should be given to alternate explanations such as increased supervision by family members working from home or unemployed during the pandemic, and/or decreased nursing home use, as ground-level fall caused 90% of hip fractures among older individuals and most falls in older individuals (80%) occur in or around the home.