Epidemiological changes and surgical trends of distal radius fractures in adults over 50 years during the COVID-19 pandemic in Korea: a nationwide repeated cross-sectional study

Background: The COVID-19 pandemic is likely to have affected bone health in older adults in Korea. This study aimed to analyze changes in the epidemiology and management of distal radius fractures (DRFs) in older adults before and during the COVID-19 pandemic.Methods: Patients with DRF aged over 50 years in 2017, 2018, 2020, and 2021 were included in this study. Patients were classified into a group with DRF occurring between 2017 and 2018 (before COVID-19) and a group with DRF occurring between 2020 and 2021 (during COVID-19). We calculated the incidence rates of DRF and compared them between the two groups. We also analyzed and compared demographic data (age, sex, income, residence) and the operation rate for DRF between the two groups. Patient selection and treatment were based on International Classification of Diseases, 10th revision codes.Results: A total of 140,634 patients with DRF (before COVID-19, 69,794; during COVID-19, 70,840) were included. The incidence of DRF before COVID-19 (184.4/100,000 person-years) was higher than during COVID-19 (169.8/100,000 person-years). The operation rate was higher during COVID-19 (86.9%) than before COVID-19 (83.3%). Conclusion: During the COVID-19 pandemic, the incidence of DRF decreased in South Korea. However, the rate of surgical treatment increased and exceeded the global surgical rate.Level of evidence: III.