Related Articles The COVID 19 Pandemic The effect on open lower limb fractures in a London major trauma centre a plastic surgery perspective Injury 2020 Dec 11 Authors Campbell E Zahoor U Payne A Popova D Welman T Pahal GS Sadigh P Abstract BACKGROUND COVID 19 has created huge pressures on healthcare systems The ongoing provision of major trauma services during this time has proved challenging We report our experience of managing open lower limb fractures oLLFs during the pandemic in a London major trauma centre MTC METHODS This was a prospective study of all open lower limb fractures presenting to our unit over the initial 48 days of UK government lockdown 24th March till 10th May 2020 Results were compared to the same time period in 2019 retrospectively Epidemiological data mechanism Gustilo Anderson G A severity grading time to initial debridement and definitive coverage were analysed RESULTS There was a 64 reduction in emergency department ED attendances 25 264 vs 9042 There was an 18 reduction in oLLFs 22 vs 18 Approximately three quarters of injuries were in males across both cohorts 77 vs 78 and tended to occur in younger patients median age 37 vs 35 Road traffic accidents RTAs were the most common injury mechanism in both 2019 and lockdown but a rise in jumpers from height was seen in the latter A similar pattern of G A severities were seen however only 3 injuries during lockdown required major soft tissue reconstruction There was no significant difference in times taken for initial debridement p 0 72786 or definitive wound coverage p 0 16152 A greater proportion of independent operating was seen during lockdown between orthopaedics and plastic surgery CONCLUSIONS Despite government lockdown measures oLLFs still placed significant burden on our MTC Notwithstanding significant staffing alterations and theatre pressures we have been able to ensure these lower limb emergencies remain a surgical priority and have managed to utilise resources appropriately PMID 33341244 PubMed as supplied by publisher