Reliability of teleconsultation in the diagnosis and treatment of proximal humeral fractures

Abstract

Purpose Teleconsultation has become a routine part of clinical practice. The question arises as to whether this is reliable or not. Various studies have assessed the reliability in fractures at other locations in the extremities, but there is no study investigating teleconsultation reliability for proximal humeral fractures, proximal humerus fractures, which are fractures that may cause difficulties in making diagnosis and treatment decisions. Our aim was to evaluate whether proximal humerus fractures could be accurately assessed via teleconsultation. Methods Retrospectively, the radiological images of 83 patients were included in the study. Diagnosis and treatment classifications were made by 4 experienced orthopedic specialists. Interobserver and intraobserver analyses were performed on diagnostic and therapeutic decisions based on two forms of evaluation, direct analysis of images in the picture archiving and communication system (PACS) and the analysis of photographs taken from the PACS computer screen that were sent via WhatsApp. Results It was observed that there were excellent interobserver and intraobserver compatibility values for Neer and AO classifications and treatment decisions. No significant difference was observed in the evaluation of the images transferred via WhatsApp and the direct evaluation of PACS images. Conclusion The reliability of teleconsultation was found to be high in the radiological evaluation of proximal humerus fractures. It is clear that these consultations cannot replace the evaluation of the patient as a whole; however, we think that rapid consultation can enable faster patient management and more accurate diagnosis, especially when under time constraints.

Assessment of discordance between radiologists and emergency physicians of RADIOgraphs among discharged patients in an emergency department: the RADIO-ED study

“…Pamuk showed that orthopedists can safely perform tele consult using their own smartphone in the radiological evaluation of proximal humerus fractures. Although it will never replace a consult in person, this "smartphone approach" is highly reliable for diagnostic and treatment-related decision [16].…”

Advancing orthopaedic trauma care through WhatsApp: An analysis of clinical and non-clinical applications, challenges, and future directions

“…The use of WhatsApp and other social media platforms by orthopaedic surgeons has been explored by Jildeh et al [ 25 ], who noted the advantages of such tools in enhancing patient-physician communication and disseminating accurate information. Studies by Pamuk[ 5 ] and Stahl et al [ 8 ] demonstrated the reliability of WhatsApp for teleconsultation and decision-making in orthopaedic trauma, respectively, with findings suggesting near-perfect agreement with traditional diagnostic methods. Further, Kapıcıoğlu et al [ 26 ] affirmed the safety and reliability of using WhatsApp for decision-making regarding paediatric supracondylar fractures, and Sumargono et al [ 27 ] reported high satisfaction rates with virtual clinics using WhatsApp for postoperative follow-up after total knee replacement surgery, emphasizing its potential continuity beyond the pandemic context.…”

“…The role of social media and mobile applications in clinical education has gained prominence, enriching the curriculum and empowering students with a wealth of knowledge and preparedness beyond traditional classroom settings[ 4 ]. Furthermore, the coronavirus disease 2019 (COVID-19) pandemic underscored the importance of teleconsultation services, necessitating adjustments in hospital workflows and highlighting the critical role of technology in maintaining continuity of care[ 5 ]. WhatsApp, in particular, has distinguished itself as a versatile tool for text and multimedia communication within the medical community[ 6 ].…”