Clavicle fracture management: A comparison of a tertiary hospital and rural telehealth sites

Abstract

The clavicle is one of the most commonly fractured bones in the adult population. Management has traditionally been conservative, however more recent research has yielded higher non-union rates associated with non-operative management. This study aims to analyse the proportion of operative and non-operative treatment methods for clavicle fracture in a tertiary hospital facility and rural health sites accessed via telehealth, comparing patient outcome between these two methods of fracture management. Following ethical approval, a retrospective review was conducted of patients presenting with clavicle fractures to the Princess Alexandra Hospital Fracture Clinics and to Orthopaedic Fracture Clinics run via teleconference with rural health sites. Only 2% of patients received operative fracture management in the telehealth group, versus 33% in the tertiary hospital sample. Patient outcome was measured in the larger tertiary hospital sample, with clinical notes reflecting good patient outcome in 70% of operatively managed patients and 85% of patients with conservatively managed clavicle fractures. For the patients in the telehealth sample that returned for follow-up appointments, 93% reported a good outcome with one of these individuals undergoing operative treatment and the rest managed conservatively.