• Eur J Trauma Emerg Surg · Feb 2025

    Efficiency of a virtual fracture clinic review protocol in adult patients with distal radial fractures requiring semi-acute surgical treatment.

    • Dorien A Salentijn, Gijs J A Willinge, Ruben N van Veen, and DijkgraafMarcel G WMGW0000-0003-0750-8790Department of Epidemiology and Data Science, Amsterdam UMC - University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands.Amsterdam Public Health, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands..
    • Department of Trauma Surgery, OLVG, Jan Tooropstraat 164, Amsterdam, 1061 AE, Netherlands. d.a.salentijn@amsterdamumc.nl.
    • Eur J Trauma Emerg Surg. 2025 Feb 7; 51 (1): 9696.

    PurposeThe aim of this study was to evaluate the effect of implementation of a Virtual Fracture Clinic (VFC) review protocol on the time between injury and surgery, and on secondary healthcare utilization, in patients with Distal Radius Fractures (DRFs) requiring semi-acute surgery.MethodsData for this retrospective before-after study were gathered between April 2017 and March 2019 (Pre-VFC n = 269), and between April 2021 and March 2023 (VFC n = 440) in a large level 2 urban trauma center. The primary outcome was the number of days between injury and operation. Furthermore secondary healthcare utilization was assessed.ResultsThe average time between injury and surgery was 11.0 days (95% CI: 10.6-11.5) before and 9.2 days (95% CI: 8.9-9.6) after VFC-implementation ( p < 0.001). Following VFC-implementation, 33% (was 17%) of patients underwent surgery within 7 days, 92% (was 84%) within 2 weeks, and 99% (was 96%) within 3 weeks (p < 0.001). This included patients with delays of up to 15 days between injury and their initial hospital presentation. Hospital contacts decreased from 5 (IQR: 4-6) to 4 (IQR: 3-5) whereof physical consults decreased from 4 (IQR: 3-5) to 1 and telephone contacts increased from negligible to 1 (IQR: 1-2). Radiographs reduced from 6 (IQR: 5-7) to 4 (IQR: 3-5).ConclusionsImplementation of a VFC-review protocol is associated with a reduced time between injury and semi-acute surgery for DRFs and reflects an improvement in quality of timely planning. Secondary healthcare utilization is reduced and a shift to remote delivery of care is observed.Level Of EvidenceLevel III.© 2025. The Author(s).

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