This retrospective cohort study found a 2.5-fold decrease in pediatric fracture volume during the COVID-19 pandemic, partially because of cessation of organized sports and decreased playground use.

• Study compared acute fractures presenting to a single level I pediatric trauma hospital during the COVID-19 pandemic with fractures during a prepandemic period at the same institution. The “pandemic” cohort was gathered from March 15 to April 15, 2020 and compared with a “prepandemic” cohort from the same time window in 2018 and 2019.
• In total, 1745 patients presenting with acute fractures were included
• The incidence of fractures presenting during the pandemic  decreased from 22.5±9.1 per day to  9.6±5.1 per day (P<0.001).
• The presenting age for all fractures decreased during the pandemic from 9.4±4.4 years to 7.5±4.3 years (P<0.001) largely due to the decreased fracture burden among adolescents.
• During the pandemic, there was an increase in the proportion of injuries occurring at home (57.8% vs. 32.5%, P<0.001) or on bicycles (18.3% vs. 8.2%, P<0.001), but a decrease in those related to sports (7.2% vs. 26.0%, P<0.001) or playgrounds (5.2% vs. 9.0%, P<0.001).
• There was no increase in time-to-presentation.