Virtual Fracture Clinic Triage and Selective Use of MRI. A Hybrid Model for Managing Suspected Scaphoid Fractures

Description

This video presentation features Nathaneal MacDonald from KSS discussing the management of scaphoid fractures, highlighting a clinical study from Frimley Park Hospital's Virtual Fracture Clinic (VFC). MacDonald begins by setting the stage for the prevalence and challenges of diagnosing scaphoid fractures, particularly through plain X-rays, and introduces the three common approaches to management across the UK, emphasizing the recently suggested role of MRI as a primary imaging tool.



The presentation details the Frimley Park approach to managing suspected scaphoid fractures, where patients are triaged for MRI based on age and impact force of the injury. This structured pathway seems effective, allowing many patients to be directly discharged from the clinic while minimizing unnecessary scans.



Through a retrospective analysis of 300 patients, it was found that only a small percentage required treatment for confirmed fractures, with many others diagnosed with soft tissue injuries. Notably, only 5% of those who underwent MRI ended up having a scaphoid fracture. MacDonald also discusses the financial implications of their approach, citing significant savings in both MRI scanner hours and clinic resources.



In conclusion, he argues for the efficiency and efficacy of the VFC model in managing scaphoid fractures while suggesting future audits to track long-term outcomes. The latter part of the video includes an engaging Q&A session where audience members inquire about the clinic's operations and referral processes, showcasing ongoing discussions about optimizing patient care in orthopedics.

DOI: 10.1302/3114-230191

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