Impact of COVID-19 lockdowns on paediatric injury patterns due to wheeled recreational vehicles in New South Wales, Australia: a cross-sectional study.

The COVID-19 pandemic and resulting lockdowns significantly disrupted the daily life of children worldwide. This study investigated the impact of these lockdowns on paediatric trauma related to wheeled recreational vehicles (including scooter, skateboard, bicycle and motorised vehicle like quadbike) in New South Wales, Australia. This retrospective cross-sectional study identified cases by using the International Classification of Diseases, Australia Modification, 12th edition external cause codes from the trauma registry and electronic medical records at two major paediatric trauma centres from March 2020 to December 2021. The study period encompassed 295 days over two COVID-19 lockdown periods (March-June 2020 and June-December 2021) and one baseline period of 361 days without lockdown (June 2020-June 2021). Demographic data, injury characteristics, management and outcomes were compared between the lockdown and no lockdown periods. Of the 1098 cases identified and analysed, 688 (63%) occurred during lockdowns. The median age was 10 years (IQR=6), with 872 (79%) being male. Wheeled recreational vehicle injuries were significantly more frequent on weekdays during lockdowns compared with no lockdown periods (66% vs 52%, p<0.01). Conversely, recreational motorised vehicle injuries decreased during lockdown when compared with no lockdown periods (15% vs 22%, p<0.05). Injury severity, injured body regions and the proportion of cases requiring operative procedures showed no significant differences between lockdown and no lockdown periods. These findings revealed a distinct shift towards weekday wheeled recreational vehicle injuries during lockdowns, reflecting the transition from structured school activities to local recreational activities. This pattern provided insights into how public health measures can influence patterns of paediatric trauma presentations, which may inform future pandemic preparedness planning.