Retrospective evaluation of allied health-led management of acute upper limb trauma
Year: 2025
Type: article
Study design: Observational Study
Abstract: Aim The ability of advanced practice allied health-led clinics to comprehensively manage acute upper limb trauma has limited evaluation. This study aimed to evaluate the safety, requirement for specialist escalation, patient satisfaction, and patient outcomes of an allied health-led upper limb fracture clinic. Methods Eligible outpatients referred to Orthopaedics with acute upper limb fractures were diverted to and managed by the allied health led Advanced Practice Hand Clinic (APHC) between August 2020 and August 2022. Patients were excluded if they did not complete treatment, were referred with chronic conditions, or simple fractures not requiring specialist care. Demographic, diagnostic, service delivery, patient satisfaction and clinical outcome data were collected as part of usual care. Descriptive statistics were used to analyse the data. Results Three hundred and twelve patients were eligible, aged median (IQR) 23 (13–47) years, 38% female, and 28% were clinical scaphoid fractures. Wait time for care was 7 (4–11) days. No adverse events were noted. Most ( n = 289, 93%) patients completed APHC treatment, with most (88%, 254/289) not requiring orthopaedic consultation. Few (7%, 23/312) patients were returned for orthopaedic management. QuickDASH scores were significantly improved at discharge (4.6 (0–9.1)) compared to initial appointment (48.9 (31.8–57.3), p < 0.001, n = 72). Most patients (98%–100%) were satisfied with wait times, seeing a hand therapist, and with their treatment received. Conclusion The APHC safely managed patients with acute upper limb trauma in lieu of Fracture Clinic, reduced reliance on Orthopaedic services, provided good functional outcomes and achieved high levels of patient satisfaction.
Source: Hand Therapy
Authors: Christopher Burton, Corinne Allsopp, Michelle A Palmer, Karina J Lewis, Iulian Nusem
Institutions: Logan Hospital, Royal Brisbane and Women's Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4417298912