This is a plain-English translation of the academic paper above, prepared for patients, referring clinicians, and other non-specialist readers. It preserves the structure of the original paper while removing technical jargon. For the full clinical paper, follow the PubMed or DOI links.
Background
Whether broken bases of fifth-metatarsal bones (a common foot fracture, usually after a twist or stumble) can be safely managed without an in-person fracture clinic visit at all — using a “virtual fracture clinic” model where the diagnosis and treatment plan are confirmed remotely from the emergency-department images. We followed 136 patients for a minimum of one year.
Rationale
Hospital fracture clinics are overstretched, and most fifth-metatarsal base fractures heal well with a walker boot and planned weaning. Bringing every such patient back for an in-person clinic visit consumes time and money without obviously changing the outcome. The trade-off is that virtual review must not miss the small number of patients who genuinely need surgery or closer follow-up.
Results
Following a standardised protocol — weight-bearing in a boot, weaning, and an open invitation to come back if pain persists past four months — 99% of patients were safely discharged at the virtual stage. Only 9% subsequently needed a face-to-face visit, mostly for ongoing pain. There was one non-union in the entire group. Compared with a traditional two-visit pathway, the virtual model saved approximately 248 clinic appointments and around £40,000.
Implications
For most patients with a typical fifth-metatarsal base fracture, a virtual fracture clinic with a clear protocol is a safe and convenient alternative to attending the hospital in person — with a clear safety net for patients whose pain doesn’t settle. The model was also financially beneficial to the NHS, freeing clinic capacity for patients with more complex injuries.
Source: Zahan N, Patel A, Atkinson K, Jha S, Heidari N, Parker L, Vris A, Malagelada F, Jeyaseelan LA. Outcomes and Cost Analysis of Virtual Fracture Clinic Management of 5th Metatarsal Base Fractures. Foot & Ankle Orthopaedics 2022. doi:10.1177/2473011421s00513
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