Abstract
Background
Access to orthopaedic care in rural and remote regions of Australia remains limited due to geographic, logistical, and resource constraints. The Mount Isa Hospital Telehealth Fracture Clinic (TFC) was established to address this disparity by delivering consultant-led fracture management via telehealth to communities across North-West Queensland.
Methods
A 12-month retrospective clinical audit of the TFC was conducted from January to December 2023. Data on clinic activity, patient demographics, attendance, fracture characteristics, treatment pathways, and outcomes were analysed. Six-month periods were compared using chi-square tests. No significant difference was observed between the two periods (n = 1550, p-value from 0.15 to 0.66), and detailed subset analysis of the first 6 months was performed to evaluate fracture types and management outcomes.
Results
A total of 1550 patients were booked across 96 telehealth clinics, with an attendance rate of 67.1%. Indigenous patients accounted for 41.1% of referrals, reflecting substantial community need. Among 340 new patients analysed in detail, 91.2% completed management within TFC and were discharged locally; 5% required surgical intervention. Most fractures were stable upper limb injuries suitable for conservative management. The failure-to-attend (FTA) rate of 32.9% highlights the need for improved engagement strategies.
Conclusion
The TFC model demonstrated high efficacy and accessibility, reducing patient travel and tertiary hospital utilisation while enabling more equitable access to orthopaedic care for remote communities. High FTA rates remain a challenge, highlighting the need for culturally responsive care models, digital literacy support, and community engagement. Telehealth represents a scalable solution for fracture management in geographically isolated populations.
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