Is there any place for the physiotherapist service in the fracture clinic?

1998 ◽  
Vol 3 (3) ◽  
pp. 134-136
Author(s):  
M. Nashi ◽  
Verna Ashby ◽  
B.N. Muddu ◽  
Maggie Tate
Keyword(s):  
Fracture Clinic

scholarly journals 20 Comparison of Six Frailty Screening Tools in Patients Aged 65+ with An Arm Fragility Fracture

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
K Ibrahim ◽  
T Lim ◽  
M A Mullee ◽  
G L Yao ◽  
S Zhu ◽  
...  
Keyword(s):  
Fragility Fracture ◽  
Frailty Index ◽  
Screening Tools ◽  
Frailty Phenotype ◽  
Fracture Clinic ◽  
Increased Risk ◽  
Sensitivity Range ◽  
Practical Tool ◽  
Acute Trust ◽  
Medication Changes

Abstract Introduction Frailty is associated with an increased risk of falling and fracture, but not routinely assessed in fracture clinic. Early identification and management of frailty among older people with arm fragility fracture could help avoid further falls and fractures, especially of the hip. We evaluated the feasibility of assessing frailty in a busy fracture clinic. Methods People aged 65+ years with an arm fracture in one acute trust were recruited. Frailty was assessed in fracture clinics using six tools: Fried Frailty Phenotype (FFP), FRAIL scale, PRISMA-7, electronic Frailty Index (e-FI), Clinical Frailty Score (CFS), and Study of Osteoporotic Fracture (SOF). The sensitivity and specificity of each tool was compared against FFP as a reference. Participants identified as frail by 2+ tools were referred for Comprehensive Geriatric Assessment (CGA). Results 100 patients (mean age 75 years±7.2; 20 men) were recruited. Frailty prevalence was 9% (FRAIL scale), 13% (SOF), 14% (CFS > 6), 15% (FFP; e-FI > 0.25), and 25% (PRISMA-7). Men were more likely to be frail than women. Data were complete for all assessments and completion time ranged from one minute (PRISMA-7; CFS) to six minutes for the FFP which required most equipment. Comparing with FFP, the most accurate instrument for stratifying frail from non-frail was the PRISMA-7 (sensitivity = 93%, specificity = 87%) while the remaining tools had good specificity (range 93%–100%) but average sensitivity (range 40%–60%). Twenty patients were eligible for CGA. Five had recently had CGA and 11/15 referred were assessed. CGA led to 3–6 interventions per participant including medication changes, life-style advice, investigations, and onward referrals. Conclusion It was feasible to assess frailty in fracture clinic and to identify patients who benefitted from CGA. Frailty prevalence was 9%—25% depending on the tool used and was higher among men. PRISMA-7 could be a practical tool for routine use in fracture clinics.

scholarly journals 688 Rapid Implementation of Virtual Fracture Clinic During COVID 19 Reduces Both Face-To-Face Appointments and Facilitates Rapid Feedback and Education to Be Delivered to The Emergency Department

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Havenhand ◽  
L Hoggett ◽  
A Bhutta
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
Prospective Data ◽  
Fracture Clinic ◽  
Face To Face ◽  
Return Rates ◽  
Acute Hospitals ◽  
Virtual Fracture Clinic ◽  
Improve Patient

Abstract Introduction COVID-19 has dictated a shift towards virtual clinics. Pennine Acute Hospitals NHS Trust serves over a million patients with a significant number of face-to-face fracture clinics. Introduction of a Virtual Fracture Clinic (VFC) reduces hospital return rates and improves patient experience. The referral data can be used to give immediate monthly feedback to the referring department to further improving patient flow. Method Prospective data was collected for all referrals to VFC during March 2020. Data included referral diagnosis, actual diagnosis, referrers grade, and final outcome. Results 630 referrals were made to VFC. 347 (55%) of those referrals were directly discharged without the need for physical consultation. Of these 114 (32%) were injuries which can be discharged by the Emergency Department with an advice leaflet using existing pathways. Of the remaining discharges 102 (29%) were query fractures or sprains; and 135 (39%) were minor fractures; which needed only advice via a letter and no face to face follow up. Conclusions Implementation of VFC leads to a decrease in physical appointments by 55% saving 347 face to face appointments. The new system has also facilitated effective audit of referrals in order to further improve patient flow from the Emergency Department via feedback mechanisms and education.

Attitudes of parents towards an urban paediatric fracture clinic

2010 ◽  
Vol 14 (2) ◽  
pp. 82-87 ◽  
Author(s):  
K.H. Teoh ◽  
Y.H. Chee ◽  
P.M. Simpson ◽  
M. Mitchell ◽  
D.E. Porter
Keyword(s):  
Fracture Clinic ◽  
Paediatric Fracture

Patients’ Perception of Military Doctors in Fracture Clinics - does the Wearing of Uniform Make a Difference?

2005 ◽  
Vol 91 (1) ◽  
pp. 45-47
Author(s):  
Christopher McLean ◽  
Pareeta Patel ◽  
Carl Sullivan ◽  
Mark Thomas
Keyword(s):  
Trauma Surgery ◽  
Trauma Surgeon ◽  
Royal Navy ◽  
Fracture Clinic ◽  
Specialist Registrar ◽  
Anonymous Questionnaire ◽  
Military Uniform ◽  
The Military

AbstractWe performed a study during our Trauma Week when patients who were referred from the accident department with fractures were reviewed in our fracture clinic. During our Trauma Week, Mister Thomas, Consultant Orthopaedic and Trauma Surgeon or Surgeon Lieutenant Commander McLean, Specialist Registrar in Orthopaedic and Trauma Surgery reviewed a total of 93 patients in fracture clinic. All patients were given an anonymous questionnaire regarding their perceptions of their attending clinician, 77 were completed. Forty-nine questionnaires regarding Surgeon Lieutenant Commander McLean and 28 regarding Mister Thomas were available for analysis. During the Trauma Week all patients were seen in the same location in identical cubicles by either of the two clinicians, consultations were typically brief lasting about five minutes. Throughout the week the clinicians, one military and one civilian, wore differing attire. The military uniform comprised Royal Navy number four action working dress. The civilian attire comprised ‘dog-robbers’ (jacket, shirt with tie and smart trousers). The hypothesis tested was that the use of military uniform might alter patients’ perceptions of their attending clinician. Our results appear to demonstrate that the attire of the attending clinician does not adversely influence patients’ perceptions of their attending clinician.

scholarly journals Does it Matter Whom You See?–A Fracture Clinic Audit

2006 ◽  
Vol 88 (6) ◽  
pp. 540-542 ◽  
Author(s):  
TDA Cosker ◽  
A Ghandour ◽  
T Naresh ◽  
K Visvakumar ◽  
SR Johnson
Keyword(s):  
Complex Trauma ◽  
Discharge Rate ◽  
Trauma System ◽  
Presentation Rate ◽  
Fracture Clinic ◽  
Complete Cycle ◽  
Junior Staff ◽  
Number Of Patients ◽  
The Uk

INTRODUCTION A consultant-led service for trauma in the UK has become the accepted norm. Practice in fracture clinics may vary widely between consultants and has an impact on the number of patients seen and, therefore, the time devoted to each patient. PATIENTS AND METHODS A total of 945 patients attending our unit's fracture clinics were analysed over a 6-week period, representing one complete cycle of our trauma system. RESULTS The overall discharge rate was 38% but this differed significantly between consultants. Patients re-presenting for the same complaint were evenly distributed between those discharging aggressively and those re-reviewing regularly. CONCLUSIONS Re-reviewing patients has a significant impact on the number of patients seen in future clinics and, therefore, the time that can be devoted to each patient, individual consultant workload and teaching of junior staff. Since the re-presentation rate between those discharging aggressively and those re-reviewing more frequently was the same, discharge protocols are recommended for common trauma conditions to standardise the process. Specialist clinics are recommended for more complex trauma cases.

scholarly journals AB066. SOH21AS168. Remote delivery of the satellite virtual fracture clinic—a pilot report of the first 500 cases

2021 ◽  
Vol 5 ◽  
pp. AB066-AB066
Author(s):  
Andrew Jerome Hughes ◽  
Darren Patrick Moloney ◽  
Caroline Fraser ◽  
Joan Dembo ◽  
Andrew Hughes ◽  
...  
Keyword(s):  
Fracture Clinic ◽  
Virtual Fracture Clinic

A FRACTURE CLINIC

1925 ◽  
Vol 10 (1) ◽  
pp. 163 ◽  
Author(s):  
ISIDORE COHN
Keyword(s):  
Fracture Clinic

A 6-month evaluation of a clinical specialist physiotherapist's role in a fracture clinic

2009 ◽  
Vol 30 (1) ◽  
pp. 8-15 ◽  
Author(s):  
A Moloney ◽  
M Dolan ◽  
L Shinnick ◽  
M Murphy ◽  
L Wallace
Keyword(s):  
Fracture Clinic ◽  
Clinical Specialist

341 Alder Hey Experience of Paediatric Virtual Fracture Clinic During The COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
L Stead ◽  
M Ashraf ◽  
S Gandham ◽  
M Khattak ◽  
C Talbot
Keyword(s):  
Patient Contact ◽  
Fracture Clinic ◽  
Social Challenges ◽  
Face To Face ◽  
Elbow Injuries ◽  
Rapid Transition ◽  
Clavicle Fractures ◽  
Alder Hey ◽  
Virtual Fracture Clinic

Abstract Introduction The SARS-CoV2/COVID-19 pandemic represented an unprecedented emergency prompting a drive to minimise non-essential patient contact and the need for a virtual fracture clinic (VFC); an uncommon practice in paediatric units. Management of paediatric fractures requires a greater degree of vigilance to safeguard children. The current climate has created social challenges that theoretically increase the risk of harm and exploitation to children. This study investigates VFC in the management of paediatric fractures to determine the efficiency of such a process and the risk of safeguarding. Method A protocol was devised in affiliation with BSCOS for the immediate management and streamlining of paediatric fractures into VFC. We retrospectively audited 235 VFC consults over a 1-month period. Patient sex was roughly evenly distributed, and age ranged from 9 months to 16 years (mean 8.4 years). Results 42% of patients were recalled for a face-to-face (F2F) review (26% expedited), primarily for clinical assessment, plaster complaints and imaging requirements. 33% were discharged and 15% continued follow-up in VFC. All clavicle fractures were discharged. Forearm, hand, foot and elbow injuries were more likely to be discharged. Lower leg, upper arm and knee presentations more frequently required a F2F review. 2.3% of cases required safeguarding reviews. Conclusions Given the rapid transition to VFC without the use of triage we have determined a number of non-complex fractures safely managed and discharged via VFC. The low percentage of recall due to safeguarding concern highlights this may not be a barrier to the continuation of virtual care outside of the context of a pandemic.

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