The impact on time between injury and semi-acute surgery for hand fractures after virtual fracture clinic implementation.

Dorien A Salentijn, Gijs J A Willinge, Marcel G W Dijkgraaf, Ruben N van Veen
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Abstract

The aim of this before-and-after study was to evaluate the implementation of a virtual fracture clinic (VFC) on the time between injury and surgery in patients presenting with a phalangeal or metacarpal fracture and in need of semi-acute surgical treatment. Between 1 January and 30 September 2018 (pre-VFC) and in the same period in 2022 (VFC), 101 and 113 patients were included, respectively. Before VCF implementation, the time between injury and surgery was 8.9 days (95% confidence interval [CI]: 8.1 to 9.6), while after VCF implementation it was 7.6 days (95% CI: 7.0 to 8.3). In 2018, 7% of operations were unacceptably delayed beyond 14 days from injury, which was reduced to 5% in 2022, despite patient-presentation delays of up to 10 days. VFC implementation was associated with a reduction in time until semi-acute surgery for phalangeal or metacarpal fractures and improved the quality of semi-acute surgery planning.Level of evidence: Level III.

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虚拟骨折诊所实施后对手部骨折从受伤到半急性手术之间时间的影响。
这项前后对比研究旨在评估虚拟骨折诊所(VFC)的实施对指骨或掌骨骨折并需要接受半急性手术治疗的患者从受伤到手术的时间间隔的影响。2018年1月1日至9月30日(VFC前)和2022年同期(VFC),分别纳入了101名和113名患者。在实施 VCF 之前,受伤与手术之间的时间间隔为 8.9 天(95% 置信区间 [CI]:8.1 至 9.6),而在实施 VCF 之后,受伤与手术之间的时间间隔为 7.6 天(95% 置信区间 [CI]:7.0 至 8.3)。2018年,有7%的手术不可接受地延迟至受伤后14天以上,2022年降至5%,尽管患者就诊延迟时间长达10天。VFC的实施与指骨或掌骨骨折半急性期手术时间的缩短有关,并提高了半急性期手术规划的质量:证据等级:三级。
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