Background: COVID-19 impacted treatment of surgical patients worldwide. Fracture incidence and volume vary with seasons and weather. How fracture incidence and volume are affected during the COVID-19 pandemic, particularly given the implementation of social distancing and stay-at-home directives, is unknown.

Objectives: Evaluate the effect of statewide social distancing and stay-at-home directives on volume and mechanism of orthopaedic trauma injuries.

Methods: Retrospective chart review of orthopaedic trauma consults March 17-April 30 in 2018, 2019, and 2020 at a Level 1 trauma center. Patient demographics and clinical data including age, sex, associated injuries, treatment location, time to presentation, length of stay, and mechanism and type of injury were obtained.

Results: 1,113 (2018: 357, 2019: 422, 2020: 334) orthopaedic trauma consult were reviewed. Chi-square goodness-of-fit showed a significant decrease in consult number in 2020 from the number expected. Number and percentage of cases treated operatively did not significantly differ. Time-to-presentation significantly increased in 2020 compared to 2018 and 2019. Consults for gunshot wounds significantly increased in 2020 compared to 2018 and 2019. Consults for automobile versus pedestrian significantly decreased in 2020 compared to 2018 and 2019.

Conclusion: During the COVID-19 pandemic, orthopaedic trauma volume and distribution in mechanisms changed. These differences in injury pattern highlight the importance of continued orthopaedic care and understanding how to adapt patient care to evolving circumstances the healthcare system may encounter. The persistent operative trauma volume demonstrates that orthopaedic surgeons are essential providers during these unprecedented times and must be prepared to provide acute treatment of orthopaedic injuries.