Assessing the frequency and utility of orthopaedic outpatient department (OPD) attendances of surgically managed distal radius and ankle fractures.

BACKGROUND& PURPOSE: Fractures of the distal radius and of the ankle are two of the most common injuries requiring fixation in orthopaedic trauma services. Guidelines recommend post-operative follow up for these injuries at two-week and six-weeks after surgery. To assess the frequency and utility of orthopaedic OPD attendances for surgically-managed distal radius and ankle fractures in an Irish Trauma Unit.

methodsWeidentified distal radius and ankle fractures needing surgery over 18 months using our electronic health records. To understand outpatient attendance reasons, we reviewed outpatient letters via the Integrated Patient Management System.

resultsFrom September 2022 to March 2024, 463 distal radius and ankle operative cases were included; 248 distal radius and 215 ankle fracture. 227 distal radius patients (92%) were followed-up at two-weeks post-operatively, while 187 (75%) were followed up at six-weeks. 169 patients (68%) were discharged at 6 weeks post-operative. 209 (97%) ankle patients attended at week 2, while 179 (83%) attended at week 6 post-operative. 123 patients (57%) were discharged at the 6 week follow-up appointment. Wound complications was the most common reason for additional follow-up in both distal radius and ankle fractures.

conclusionMost operative distal radius and ankle fracture patients are discharged at 6 weeks without change to their management. Wound-related complications were the most common reason for additional attendances. Outpatient clinics may be optimised by reducing follow-up of non-complex cases to a single 6 week appointment with additional strategies for wound care in specific patients.