Fracture diagnostics, unnecessary travel and treatment: a comparative study before and after the introduction of teleradiology in a remote general practice

Table 4 Physical examination, diagnosis, and treatment in trauma patients in 2006 and 2009

	2006						2009
Physical examination	1: Deformity	2: Axial compression pain		3: Local pressure pain		Total: 1, 2, 3 2006	1: Deformity	2: Axial compression pain		3: Local pressure pain		Total: 1, 2, 3 2009
1. Number of patients	23	67		181		271	37	162		186		385
2. Suspicion of fracture ¹		Direct	After two days	Direct	After two days			Direct	After two days	Direct	After two days
a. No	0	9	0 + 4²	181	165 + 5²	165 + 9²	0	0	0	168	119 + 2²	119 + 2²
b. Yes	23	58	5	0	11	97	37³	162	0	16 + 2⁴	47	264
3. Treatment by GP without x-ray c. No fracture	0	0	4	181	170	174	0	0	0	168	121	121
b Fracture	3⁵	12⁶	0	0	0	15^5,6	0	0	0	0	0	0
4. Result of x-ray (hospital in 2006 and general practice in 2009): d. No fracture	0	31	2	0	8	41	0	103	0	6 + 2⁴	47	158
e. Fracture	20	15	3	0	3	41	36 + 1³	59	0	10	0	106
5. Treatment by GP after x-ray: f. No fracture	0	31	2	0	8	41	0	103	0	6 + 2⁴	47	158
g. Fracture	0	0	0	0	0	0	6	53	0	10	0	69
6. Treatment Hospital: fractures (only)	20	15	3	0	3	41	31	6	0	0	0	37

Notes:
¹Fractures = Fractures and/or dislocations.
²Missed fractures.
³One patient with a complicated tibia/fibular fracture was sent directly to the hospital without obtaining an x-ray at the general practice.
⁴Two patients with a high-energy trauma were sent directly to the hospital (CT-scans indicated).
⁵Three patients with habitual shoulder dislocation were treated by the GP without x-rays.
⁶Twelve patients with phalanx fractures were treated by the GP without x-rays.

ISSN: 2731-4553