Aim: To evaluate the outcomes of orthopaedic consultant-led virtual fracture clinics (VFC) for upper and lower limb fractures and musculoskeletal injuries implemented at The Royal Melbourne Hospital since March 2017.
Methods: We conducted a retrospective analysis of referrals managed by the VFC from March 2017 to March 2024. Key outcomes assessed included the proportion of patients discharged by the VFC without requiring orthopaedic outpatient clinic care, reasons for onward referral to outpatient clinics, and the types of conditions most frequently discharged by the VFC. Data were extracted from a prospective project database.
Results: A total of 11,465 referrals were reviewed by the VFC. The cohort consisted of 54.6% male patients with an average age of 42 years (range 16-102). The most common conditions referred included wrist fractures (12.5%), glenohumeral dislocations (7.9%), radial head/neck fractures (7.9%), and metatarsal fractures (7.3%). Overall, 38.4% of patients were discharged directly by the VFC, avoiding traditional outpatient orthopaedic clinic care. Among the remaining patients, 78.5% were referred to outpatient clinics, as in person review was determined necessary by the orthopaedic consultant. Conditions with the highest rates of VFC discharge included ankle sprains (68.9%), radial head/neck fractures (68.4%), metatarsal fractures (63.4%), and foot phalanx fractures (59.1%).
Conclusion: Radial head/neck fractures and metatarsal fractures were identified as high-volume conditions with significant rates of direct discharge from the VFC. Targeting these conditions initially when implementing the VFC model may optimize resource utilization and reduce outpatient clinic burden effectively.