This study aimed to determine the effects of virtual fracture care (VFC) on secondary healthcare utilization in non-operative treatment of adult patients with a distal radial fracture. A retrospective cohort study was performed, including those who received non-operative treatment without VFC (pre-VFC) and with VFC (VFC). Outcomes included secondary healthcare utilization, calculated treatment costs, emergency department (ED) reattendances and complication rates. In total, 88 pre-VFC and 99 VFC patients were included. Pre-VFC patients had more follow-up appointments, with a median of 4 (IQR: 3) versus a median of 4 (IQR: 1) in VFC patients. In addition, 3% of follow-up appointments for pre-VFC patients were performed remotely compared to 18% for VFC patients. Complications and ED reattendances were comparable between groups. In this study, non-operative treatment of adult patients with a distal radial fracture through VFC reduced secondary healthcare utilization, with similar reported complication and ED reattendance rates compared with treatment without VFC.
BeerekampMSHde Muinck KeizerRJOSchepNWLUbbinkDTPannemanMJMGoslingsJC.Epidemiology of extremity fractures in the Netherlands. Injury. 2017,
48: 1355–62.
2.
BellringerSFBroganKCassidyLGibbsJ.Standardised virtual fracture clinic management of radiographically stable Weber B ankle fractures is safe, cost effective and reproducible. Injury. 2017,
48: 1670–3.
BoersmaEZHekmaEJKraaijvangerNMollenRNijhuis-van der SandenMWGEdwardsMJR.Cast-off trial: One versus 4 to 5 weeks of plaster cast immobilization for nonreduced distal radius fractures: A randomized clinical feasibility trial. Hand (N Y). 2022,
17: 60S–9S.
5.
BroganKBellringerSAkehurstH, et al.
Virtual fracture clinic management of fifth metatarsal, including Jones’, fractures is safe and cost-effective. Injury. 2017,
48: 966–70.
6.
BuvikABergmoTSBuggeESmaabrekkeAWilsgaardTOlsenJA.Cost-effectiveness of telemedicine in remote orthopedic consultations: Randomized controlled trial. J Med Internet Res. 2019,
21: e11330.
7.
DaveyMSCoveneyERowanFCassidyJTClearyMS.Virtual fracture clinics in orthopaedic surgery - a systematic review of current evidence. Injury. 2020,
51: 2757–62.
8.
Di CostanzoC.Healthcare resource allocation and priority-setting. A European challenge. Eur J Health Law. 2020,
27: 93–114.
9.
DunkerleySKurarLButlerKJamesMLowdonI.The success of virtual clinics during covid-19: A closed loop audit of the British Orthopaedic Association (BOAST) guidelines of outpatient orthopaedic fracture management. Injury. 2020,
51: 2822–6.
10.
DuttaACrateGBaktiNNichollJ.Management of scaphoid fractures with CT scanning and virtual fracture clinic pathway reduces need for face-to-face clinic appointments. Ann R Coll Surg Engl. 2021,
103: 678–82.
11.
EkelandAGBowesAFlottorpS.Effectiveness of telemedicine: A systematic review of reviews. Int J Med Inform. 2010,
79: 736–71.
12.
EvansDHardmanJMiddletonSDAnakweRE.Developing a virtual fracture clinic for hand and wrist injuries. J Hand Surg Eur. 2018,
43: 893–4.
13.
FaheyEElsheikhMFHDaveyMSRowanFCassidyJTClearyMS.Telemedicine in orthopedic surgery: A systematic review of current evidence. Telemed J E Health. 2022,
28: 613–35.
GeerdinkTHAugustinusSGroenJJ, et al.
Direct discharge from the emergency department of simple stable injuries: A propensity score-adjusted non-inferiority trial. Trauma Surg Acute Care Open. 2021,
6: e000709.
16.
GeerdinkTHGeerdinkNJvan DongenJM, et al.
Cost-effectiveness of direct discharge from the emergency department of patients with simple stable injuries in the Netherlands. Trauma Surg Acute Care Open. 2021,
6: e000763.
17.
GeerdinkTHHaverlagRvan VeenRNBouwmeesterOVAGoslingsJC. [
Direct discharge from the ED for patients with simple stable injuries: A Dutch pilot study]. Ned Tijdschr Geneeskd. 2020, 164: D4604.
18.
GeerdinkTHSalentijnDAde VriesKA, et al.
Optimizing orthopedic trauma care delivery during the covid-19 pandemic. A closed-loop audit of implementing a virtual fracture clinic and fast-track pathway in a Dutch level 2 trauma center. Trauma Surg Acute Care Open. 2021,
6: e000691.
19.
GeerdinkTHUijterwijkBAMeijerDT, et al.
Adoption of direct discharge of simple stable injuries amongst (orthopaedic) trauma surgeons. Injury. 2021,
52: 774–9.
20.
GrahamSLostisEPearceOKellyM.Telephone fracture clinic consultations: A satisfactory solution in lockdown. Cureus. 2021,
13: e14371.
21.
HaiderZAweidBSubramanianPIranpourF.Telemedicine in orthopaedics during covid-19 and beyond: A systematic review. J Telemed Telecare. 2022,
28: 391–403.
22.
Hakkart-van RoijenL vdLNBouwmansCKantersTTanSS. Richtlijn voor het uitvoeren van economische evaluaties in de gezondheidszorg, bijlage 1: Kostenhandleiding: Methodologie van kostenonderzoek en referentieprijzen voor economische evaluaties in de gezondheidszorg. Zorginstituut Nederland, 2015.
23.
HerrenDBVerstrekenFLluchANaquiZvan der HeijdenB.The impact of covid-19 pandemic on hand surgery: A FESSH perspective. J Hand Surg Eur. 2022,
47: 562–7.
24.
HughesAJFeeleyIHCrowleyMConlonBMerghaniKSheehanEC.Upscaling virtual fracture clinic use is a safe, effective measure in the delivery of trauma care. J Orthop Trauma. 2020,
34: e349–e52.
25.
KarlJWOlsonPRRosenwasserMP.The epidemiology of upper extremity fractures in the United States, 2009. J Orthop Trauma. 2015,
29: e242–4.
26.
LeeGCloughOTHayterE, et al.
Embracing virtual outpatient clinics in the era of covid-19. Bone Jt Open. 2021,
2: 301–4.
27.
LittleMHuntleyDMorrisJJozsaFHardmanJAnakweRE.The virtual fracture clinic improves quality of care for patients with hand and wrist injuries: An assessment of 3709 patients. J Hand Surg Eur. 2020,
45: 748–53.
28.
McKirdyAImbuldeniyaAM.The clinical and cost effectiveness of a virtual fracture clinic service: An interrupted time series analysis and before-and-after comparison. Bone Joint Res. 2017,
6: 259–69.
NellansKWKowalskiEChungKC.The epidemiology of distal radius fractures. Hand Clin. 2012,
28: 113–25.
31.
O’DriscollCSHughesAJMcCabeFJHughesEQuinlanJFO’DalyBJ.Virtual fracture clinic reduces patient x-ray volume for common wrist and ankle fractures. Ir J Med Sci. 2022,
191: 2117–21.
32.
StanleyCKellyMElzakiMButlerACondonFLenehanB.Lessons from lockdown: Virtual clinics and service reorganisation in fracture management during covid 19 experience of an Irish regional trauma unit. Surgeon. 2021,
19: e325–e30.
33.
StirlingPHCSimpsonCJRingDDuckworthADMcEachanJE.Virtual management of clinically suspected scaphoid fractures. Bone Joint J. 2022,
104-B: 709–14.
34.
ThatcherMDThatcherMWSmithMCMcCarronMReedJ.Opportunity costs of attending surgical clinic appointments and experiences with telemedicine for follow-up care. SAGE Open Med. 2021,
9: 20503121211045247.
WhiteTOMackenzieSPCarterTH, et al.
The evolution of fracture clinic design: The activity and safety of the Edinburgh trauma triage clinic, with one-year follow-up. Bone Joint J. 2017,
99-B: 503–7.
