Virtual Fracture Clinics: Are They Truly Safe and Cost-Effective?

The face-to-face traditional fracture clinic (TFC) model for managing acute musculoskeletal trauma in the UK has faced increasing criticism for being inefficient, costly, and often failing to meet timely specialist review standards. In response, the virtual fracture clinic (VFC) model was introduced, replacing automatic physical appointments with a consultant-led virtual review of clinical notes and radiographs to appropriately triage patients. This narrative review examines the current evidence on the safety, efficacy, and cost-effectiveness of this virtual approach. Evidence strongly supports the VFC model's safety, with systematic reviews covering over 63,000 patients reporting low re-attendance rates (under 5%) and minimal missed diagnoses, comparable to or better than TFCs. The VFC structure enhances clinical governance, routinely achieving compliance rates above 83% for the national standard of specialist review within 72 hours, a significant improvement over the performance of many traditional clinics. Furthermore, the economic case is robust, with VFCs consistently demonstrating substantial cost savings for healthcare systems by reducing unnecessary appointments and optimizing consultant time. Patient satisfaction is generally high, primarily due to convenience, though ensuring high-quality, structured communication and robust safety-netting is essential to mitigate concerns related to the lack of physical examination. Overall, VFCs provide a safe, efficient, and cost-effective method for managing selected injuries, serving as a critical complementary tool that reserves physical clinic capacity for patients with complex needs.