Aim In the literature, one can find information on systemic changes in outpatient care in hand surgery, which consist in limiting the frequency of follow-up visits in specialist clinics, in favour of self-control performed by patients themselves. The objective of this study was to evaluate the effectiveness and safety of this method after simple fractures of the hand and wrist. Material and methods 202 patients, 117 males (58%) and 85 females (42%) at mean 57 years of age, with stable, non- or minimally displaced hand and wrist bone fractures were enrolled in the study. Patients were treated conservatively by immobilization in a plaster or thermoplastic splint, or functionally, without any immobilization. After one visit to the clinic and receiving instructions on how to deal with a broken finger or hand, the patients were dismissed with recommendation to remove the plaster splint after 4-5 weeks and start using the hand. After 2 months all patients were interviewed by phone, asking about the course of treatment and satisfaction with this method of care. Results 179 patients (89%) were fully satisfied with the self-monitoring program, and 23 (11%) were partially satisfied. The most common problems in these patients were pain at the fracture site and limited mobility of the affected finger or wrist. No complications requiring hospitalization and surgery were found. Conclusions The change in the post-fracture care system from a traditional to a self-monitoring has shown great effectiveness and safety for patients. This improved the work of the hand clinic, improved patients’ access, increased satisfaction and reduced costs.
Żyluk et al. (Thu,) studied this question.