Our Summary

This research paper is about a study conducted to understand the effectiveness of a virtual pathway to manage patients who might have a specific type of wrist bone fracture (scaphoid fracture) that was not visible in initial x-rays. Over a year, 221 patients were referred to this virtual pathway, which involved their x-rays being reviewed by a specialist hand surgeon, and the patients could request follow-ups if needed.

The patients’ wellbeing and satisfaction were measured using several tools, including surveys about hand, arm and shoulder disabilities (QuickDASH), health-related quality of life (EQ-5D-5L), and their willingness to recommend the service to others (NPS). The researchers also noted if the patients were able to return to work.

The results showed that the majority of patients (86%) were discharged with advice, and a small percentage (9%) were called back for further review. A few patients (6%) initiated follow-up, but no fractures or ligament injuries were identified in this group. The health and satisfaction scores were generally high, with 97% of patients being satisfied with their treatment. There were no reported cases of unresolved painful fractures a year after the injury.

The study concluded that the virtual pathway for managing patients with a suspected scaphoid fracture was effective - patients were satisfied, their health and wellbeing were good, and there were no negative effects in most cases.

FAQs

  1. What is the virtual pathway used in managing patients with a suspected scaphoid fracture?
  2. How were the patients’ wellbeing and satisfaction measured in the study?
  3. What were the results of the study on the effectiveness of a virtual pathway for managing patients with a suspected scaphoid fracture?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scaphoid fracture surgery is to follow post-operative instructions carefully to ensure proper healing. This may include keeping the affected wrist elevated, wearing a splint or cast as directed, attending physical therapy appointments, and avoiding activities that could put stress on the healing bone. It’s important to communicate any concerns or changes in symptoms to your healthcare provider to ensure the best possible outcome.

Suitable For

Based on this study, it can be inferred that patients who are typically recommended scaphoid fracture surgery are those who have a confirmed fracture or ligament injury that requires further treatment beyond conservative management. Surgery may be recommended for patients who do not show improvement with non-surgical treatments, such as casting or immobilization, or for cases where the fracture is displaced or unstable. Additionally, patients who have persistent pain or limited function in the affected wrist may also be candidates for surgery to help restore proper alignment and function.

Timeline

Before scaphoid fracture surgery:

  • Patient experiences trauma or injury to the wrist
  • Patient may experience pain and swelling in the wrist
  • Patient undergoes initial x-rays to diagnose the fracture
  • If the fracture is not visible in initial x-rays, patient may be referred to a specialist hand surgeon for further evaluation
  • Patient may experience uncertainty and anxiety about the diagnosis and treatment plan

After scaphoid fracture surgery:

  • Patient undergoes surgery to stabilize the fracture with screws or pins
  • Patient may experience pain and discomfort after surgery
  • Patient may require physical therapy to regain strength and range of motion in the wrist
  • Patient may have follow-up appointments with the surgeon to monitor healing and remove hardware if necessary
  • Patient may gradually return to normal activities and work once the wrist is healed
  • Patient may experience improvements in hand, arm, and shoulder function and quality of life as they recover from surgery

What to Ask Your Doctor

  1. What is a scaphoid fracture and why is surgery necessary?
  2. What are the potential risks and complications associated with scaphoid fracture surgery?
  3. What is the expected recovery time and rehabilitation process after scaphoid fracture surgery?
  4. How will you determine if surgery is the best treatment option for my scaphoid fracture?
  5. What type of anesthesia will be used during the surgery?
  6. How experienced are you in performing scaphoid fracture surgery?
  7. What are the success rates for scaphoid fracture surgery?
  8. Will I need to wear a cast or splint after the surgery, and for how long?
  9. What type of physical therapy or exercises will be recommended after the surgery?
  10. How long will it take for me to return to my normal activities, such as work or sports, after the surgery?

Reference

Authors: Stirling PHC, Simpson CJ, Ring D, Duckworth AD, McEachan JE. Journal: Bone Joint J. 2022 Jun;104-B(6):709-714. doi: 10.1302/0301-620X.104B6.BJJ-2021-1464.R2. PMID: 35638214