Fracture Clinic is Changing

Fracture Clinic is changing to Virtual Fracture Clinic (VFC)

It’s been found that 30% of patients referred to fracture clinic where discharged with only advice and guidance it was also found that another 30% of patients could have had a more appropriate first appointment and avoid multiple attendances.

With this in mind when we refer to fracture clinic from ED the patients should be given an advice sheet that will explain how the VFC will work and what to expect.
There will be 24 slots cross site Sunday to Thursday. These are booked via reception, using new style “Clinic Appointment Request” cards. 
Once these slots are full (and Friday/Saturday) reception will revert to regular “face-to-face” slots. This is not something you need to worry about as a clinician. Just refer them to the clinically appropriate slot (VFC or traditional) and admin people will do their magic and make it work.
The orthopaedic team will then review the patients ED notes and xrays and organise a management plan even if they decide no follow up is needed. The patient will be contacted directly from VFC with any follow questions and advice/appointments.
This is now live, but the process is being closely monitored and further tweaks are to be expected. 

Patients that will not be suitable & need a “face-to-face” as below

  • Homeless patients
  • Prisoners
  • Non English Speaking Patients
  • Inpatients
  • Patients with Hearing Difficulties
  • Phoneless Patients
  • Injuries Associated with Domestic or Child Abuse
  • Children under 2 Years of Age

Injuries appropriate for self-care (NO face-face clinic or VFC required)

  • Volar plate avulsions –
    • Less than 50% of articular surface
    • Isolated simple fracture without complication
    • Closed
    • No dislocation/subluxation of joint
    • Advice Leaflet
  • Torus ‘Buckle’ Fractures of the distal radius – 
  • Metatarsal fractures – 
    • Isolated simple fracture without complication
    • Closed
    • Single Distal Metatarsal Fracture
    • Single zone 1 or 2 fractures
    • Not suspicious of a Lisfranc type injury
    • Advice Leaflet
  • Toe fractures
  • Paediatric clavicle fractures –

Fracture clinic are currently undertaking surveillance of all patients discharged without follow up who fall into these categories for quality control. If you discharge someone then please fill out the online form which can be found here. (links also available on all the computers in Minors across both sites)

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