Objectives: The aim of this study is to investigate the effectof the novel coronavirus-2019 (COVID-19) pandemic on theoperational trends in the orthopedic surgery department of atertiary referral center.Patients and methods: A total of 305 orthopedic surgicalprocedures in 245 patients (136 males, 109 females; mean age:34±26.6 years; range, 0 to 91 years) between March 16th and June27th, 2020 were retrospectively analyzed. The same period of theyear before including 860 procedures in 783 patients (364 males,419 females; mean age: 33.6±25.8 years; range, 0 to 95 years)was also reviewed as a pre-pandemic control group. Patientdemographics, surgical indications, COVID-19 polymerasechain reaction (PCR) test status, method of anesthesia, surgicalsubspecialties (trauma, sports, etc.), trauma mechanisms, andsurgical priorities were evaluated. The pandemic and the prepandemic periods were compared.Results: The rate of elective surgeries decreased comparedto the previous year, and priority C type surgeries had thehighest frequency (42.5%). Orthopedic trauma was the leadingsubspecialty with 91 (29.8%) cases and had a higher share,compared to the pre-pandemic period (17.0%). Hip fractures(18.7%) were the most common cause of trauma surgery, andsimple falls (42.3%) composed the largest group of traumamechanisms, which was similar to the pre-pandemic period(hip fractures, 13.6%; simple falls, 42.5%). The distribution ofsurgical urgency levels and subspecialties differed significantlybetween the pre-pandemic and pandemic periods (p<0.001). Posthoc analysis of subspecialty distribution revealed a significantdecrease in arthroplasty (p=0.002) and hand surgery (p<0.001),and a significant increase in trauma (p<0.001) and the “other”category (p<0.001).Conclusion: Our experience in a tertiary referral centerillustrated a shift toward performing emergent and urgentsurgeries, when the severity of the outbreak increased.Prioritizing surgical urgencies during the outbreak changed theorthopedic surgery practice with an emphasis on trauma andoncology surgeries. Hip fractures were the most common causeof trauma surgery, and simple falls composed the largest groupof trauma mechanisms.