{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:26:21Z","timestamp":1762431981289},"reference-count":26,"publisher":"Royal College of Surgeons of England","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2021,2]]},"abstract":"Introduction<\/jats:title> Non-injury-related factors have been extensively studied in major trauma and have been shown to have a significant impact on patient outcomes. Mental illness and associated medication use has been proven to have a negative effect on bone health and fracture healing. <\/jats:p><\/jats:sec>Materials and methods<\/jats:title> We collated data retrospectively from the records of orthopaedic inpatients in a non-COVID and COVID period. We analysed demographic data, referral and admission numbers, orthopaedic injuries, surgery performed and patient comorbidities, including psychiatric history. <\/jats:p><\/jats:sec>Results<\/jats:title> There were 824 orthopaedic referrals and 358 admissions (six\/day) in the non-COVID period, with 38\/358 (10.6%) admissions having a psychiatric diagnosis and 30\/358 (8.4%) also having a fracture. This was compared with 473 referrals and 195 admissions (three\/day) in the COVID period, with 73\/195 (37.4%) admissions having a documented psychiatric diagnosis and 47\/195 (24.1%) having a fracture. <\/jats:p><\/jats:sec>Discussion<\/jats:title> There was a reduction in the number of admissions and referrals during the pandemic, but a simultaneous three-fold rise in admissions with a psychiatric diagnosis. The proportion of patients with both a fracture and a psychiatric diagnosis more than doubled and the number of patients presenting due to a traumatic suicide attempt almost tripled. <\/jats:p><\/jats:sec>Conclusion<\/jats:title> While total numbers using the orthopaedic service decreased, the impact of the pandemic and lockdown disproportionately affects those with mental health problems, a group already at higher risk of poorer functional outcomes and non-union. It is imperative that adequate support is in place for patients with vulnerable mental health during these periods, particularly as we look towards a potential \u2018second wave\u2019 of COVID-19. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2020.7026","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T10:27:52Z","timestamp":1612866472000},"page":"114-119","source":"Crossref","is-referenced-by-count":9,"title":["The effect of the COVID-19 pandemic on mental health associated trauma, admissions and fractures at a London major trauma centre"],"prefix":"10.1308","volume":"103","author":[{"given":"D","family":"Hay","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MS","family":"Jamal","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Kings College 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