Efficiency of virtual fracture clinic review in conservative treatment of patients with a distal radius fracture

Abstract text (incl. references and figure legends)

Introduction

In recent years, Virtual Fracture Clinics (VFC) have been widely accepted in management of trauma patients. VFC focuses on increased remote care delivery and efficient planning of follow-up (FU). 1 This study aimed to determine the effect of VFC in patients with a distal radius fracture requiring conservative treatment.

Materials & Methods

This retrospective cohort study included adult patients with conservatively treated distal radius fractures, between May 2020 and January 2021, treated at an urban level 2 trauma center, across two sites. Patients at site one received traditional treatment (pre-VFC group), patients at site two were treated through VFC (VFC group). Outcomes included secondary healthcare utilization, treatment completion within three months, and complications.

Results

In total, 88 pre-VFC and 99 VFC patients were included. Baseline characteristics were similar between groups. VFC patients had less follow-up (FU) consultations, with a total of 385 (median:4, IQR 1) in the pre-VFC group vs. 353 (median:4, IQR3) in the VFC group (p<0.01). In pre-VFC patients, 97% of FU consultation was done face-to-face and 3% by phone. In VFC patients, this was 82% and 18%, respectively (p<0.01). Regarding distribution of FU consultations among caregivers, physician assistants attended more FU consultations in the VFC group, with 5% vs. 1% in the pre-VFC group (p<0.01). Treatment completion within three months was achieved in 87 (93.5%) pre-VFC patients and 97 (93.3%) VFC patients (p=0.93). Radiographic imaging during FU and complications did not differ significantly between groups.

Conclusions

VFC resulted in a reduction of FU consultations and increased remote delivery of care. Treatment completion within 3 months and complication rate were comparable between groups.

References

1. Davey MS et al. Virtual Fracture Clinics in Orthopaedic Surgery - A Systematic Review of Current Evidence. Injury. 2020;51(12):2757-2762

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