Blank Elizabeth, Lappan Charles, Belmont Philip J, Machen M Shaun, Ficke James, Pope Richard, Owens Brett D
Orthopaedic Surgery Department, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920, USA.
J Surg Orthop Adv. 2011 Spring;20(1):50-5.
Telemedicine is a recent development, designed to assist patients with limited physical access to expert subspecialty medical care. The United States Army has established a telemedicine program, consisting of e-mail consultations from deployed health care providers to subspecialty consultants. Orthopaedic surgery became a participating consultant group in July 2007. The goal of this study is to describe the Army's telemedicine orthopaedic program and to review its progress and achievements. All consults initiated from July 2007 through April 2009 were reviewed. A total of 208 consults were received by the telemedicine orthopaedic consultation program. Predominant regions of origin were Iraq, Navy Afloat, and Afghanistan. The Army accounted for the majority of consults. Prevalent musculoskeletal complaints were fracture, sprain, neuropathy, and tendon injury. Of the 74 fracture consultations, hand and wrist fractures were most common. Symptomatic treatment or casting/splinting were the most common recommended treatments for all orthopaedic consults. Of the 170 consults requesting specific treatment recommendations for patients who likely otherwise would have been evacuated for further evaluation, surgical intervention or medical evacuation was only recommended in 25% and 16% of the consultations, respectively. The novel Army telemedicine orthopaedic consultation program developed for combat-deployed service members provides expert treatment recommendations for a variety of musculoskeletal injuries. Deployed health care providers located in austere combat environments can better determine both the necessity of medical evacuation and appropriate treatments for service members with musculoskeletal injuries when aided by orthopaedic surgery consultants, thereby limiting the number of unnecessary medical evacuations.
远程医疗是一项最新发展成果，旨在帮助那些在获取专家亚专科医疗护理方面存在身体限制的患者。美国陆军已经建立了一个远程医疗项目，该项目包括从部署在外地的医疗服务提供者向亚专科顾问进行电子邮件咨询。骨科手术于2007年7月成为参与咨询的顾问组之一。本研究的目的是描述陆军的远程医疗骨科项目，并回顾其进展和成就。对2007年7月至2009年4月发起的所有咨询进行了审查。远程医疗骨科咨询项目共收到208份咨询。主要来源地区是伊拉克、海军舰艇以及阿富汗。陆军的咨询占多数。常见的肌肉骨骼疾病主诉为骨折、扭伤、神经病变和肌腱损伤。在74例骨折咨询中，手部和腕部骨折最为常见。对症治疗或石膏固定/夹板固定是所有骨科咨询中最常见的推荐治疗方法。在170例为可能原本会被后送进行进一步评估的患者请求特定治疗建议的咨询中，分别只有25%和16%的咨询建议进行手术干预或医疗后送。为作战部署的军人开发的新型陆军远程医疗骨科咨询项目为各种肌肉骨骼损伤提供了专家治疗建议。当得到骨科手术顾问的协助时，身处严峻作战环境的部署医疗服务提供者能够更好地确定医疗后送的必要性以及对患有肌肉骨骼损伤的军人的适当治疗方法，从而减少不必要的医疗后送数量。
