Department of Orthopaedics, Tallaght University Hospital, Dublin 24, Ireland.
Ir J Med Sci. 2022 Oct;191(5):2117-2121. doi: 10.1007/s11845-021-02812-y. Epub 2021 Oct 16.
Virtual fracture clinics (VFC) have been widely adopted worldwide as part of the changes in healthcare delivery during the COVID-19 pandemic. They have been shown to be a safe and effective method of delivering trauma care for injuries which do not require immediate intervention or specialist management, whilst maintaining high levels of patient satisfaction.
Our aim was to evaluate whether VFCs reduce the volume of X-rays performed for common fractures of the wrist and ankle.
A retrospective cohort review was performed. The pre-VFC group consisted of 168 wrist and 108 ankle referrals from March to September 2019. The VFC group included 75 wrist and 68 ankle referrals, during the period March to September 2020. The total number of X-ray images, carried out within a 3-month period for each fracture was summated, with statistical analysis performed following fracture pattern classification.
A statistically significant decrease in mean X-rays was observed for isolated stable fracture patterns, such as non-displaced distal radius, - 0.976 (p = 0.00025), and Weber A ankle fractures, - 0.907 (p = 0.000013). A reduction was also observed for more complex fracture patterns such as dorsally displaced distal radius, - 0.701 (p = 0.129) and Weber B ankle fractures, - 0.786 (p = 0.235), though not achieving statistical significance.
Virtual fracture clinics can reduce X-ray frequency for common stable wrist and ankle fractures, with resultant benefits for both patients and healthcare systems. These benefits may be sustained in patient care beyond the current COVID-19 pandemic.
虚拟骨折门诊 (VFC) 已在全球范围内广泛采用，作为 COVID-19 大流行期间医疗保健服务模式转变的一部分。它们已被证明是一种安全有效的方法，可以为不需要立即干预或专科管理的创伤提供护理，同时保持高水平的患者满意度。
我们的目的是评估 VFC 是否可以减少常见腕部和踝部骨折的 X 射线检查量。
进行了回顾性队列研究。VFC 前组包括 2019 年 3 月至 9 月的 168 例腕部和 108 例踝部转诊患者，VFC 组包括 2020 年 3 月至 9 月的 75 例腕部和 68 例踝部转诊患者。对每个骨折部位在 3 个月内进行的 X 射线图像总数进行汇总，并对骨折模式分类后进行统计分析。
观察到稳定型孤立性骨折模式的 X 射线平均数量显著减少，例如无移位的桡骨远端骨折减少了 0.976（p=0.00025），Weber A 型踝关节骨折减少了 0.907（p=0.000013）。对于更复杂的骨折模式，如背侧移位的桡骨远端骨折减少了 0.701（p=0.129）和 Weber B 型踝关节骨折减少了 0.786（p=0.235），虽然没有达到统计学意义，但也观察到了减少。
虚拟骨折门诊可以减少常见稳定型腕部和踝部骨折的 X 射线频率，从而使患者和医疗保健系统都受益。这些益处可能在当前 COVID-19 大流行之外的患者护理中得以维持。
