Journal article 710 views 65 downloads
Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
,
Rhys Whelan ,
I. Dougie Russell,
Wing Man,
Paul Williams,
Andrew Bebbington
Bone and Joint Open, Volume: 3, Issue: 9, Pages: 726 - 732
Swansea University Author:
Owen Bodger
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© 2022 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence
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DOI (Published version): 10.1302/2633-1462.39.bjo-2022-0077.r1
Abstract
AimsWe introduced a self-care pathway for minimally displaced distal radius fractures, which involved the patient being discharged from a Virtual Fracture Clinic (VFC) without a physical review and being provided with written instructions on how to remove their own cast or splint at home, plus advic...
| Published in: | Bone and Joint Open |
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| ISSN: | 2633-1462 |
| Published: |
British Editorial Society of Bone & Joint Surgery
2022
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa61625 |
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| Abstract: |
AimsWe introduced a self-care pathway for minimally displaced distal radius fractures, which involved the patient being discharged from a Virtual Fracture Clinic (VFC) without a physical review and being provided with written instructions on how to remove their own cast or splint at home, plus advice on exercises and return to function.MethodsAll patients managed via this protocol between March and October 2020 were contacted by a medical secretary at a minimum of six months post-injury. The patients were asked to complete the Patient-Rated Wrist Evaluation (PRWE), a satisfaction questionnaire, advise if they had required surgery and/or contacted any health professional, and were also asked for any recommendations on how to improve the service. A review with a hand surgeon was organized if required, and a cost analysis was also conducted.ResultsOverall 71/101 patients completed the telephone consultation; no patients required surgery, and the mean and median PRWE scores were 23.9/100 (SD 24.9) and 17.0/100 (interquartile range (IQR) 0 to 40), respectively. Mean patient satisfaction with treatment was 34.3/40 (SD 9.2), and 65 patients (92%) were satisfied or highly satisfied. In total there were 16 contact calls, 12 requests for a consultant review, no formal complaints, and 15 minor adjustment suggestions to improve patient experience. A relationship was found between intra-articular injuries and lower patient satisfaction scores (p = 0.025), however no relationship was found between PRWE scores and the nature of the fracture. Also, no relationship was found between the type of immobilization and the functional outcome or patient satisfaction. Cost analysis of the self-care pathway V traditional pathway showed a cost savings of over £13,500 per year with the new self-care model compared to the traditional model.ConclusionOur study supports a VFC self-care pathway for patients with minimally displaced distal radius fractures. The pathway provides a good level of patient satisfaction and function. To improve the service, we will make minor amendments to our patient information sheet. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
The authors report that they received open access funding for their manuscript from the Bevan Commission. |
| Issue: |
9 |
| Start Page: |
726 |
| End Page: |
732 |