Improving emergency department management of paediatric clavicle fractures: a complete audit cycle

• Published in: British journal of hospital medicine (London, England : 2005) Vol. 75; no. 5; p. 287
• Main Authors: Matthews, A H, Boyd, M, Bott, A R, Metcalfe, J E
• Format: Journal Article
• Language: English
• Published: England 01.05.2014
• Subjects: Adolescent; Child; Child, Preschool; Clavicle - injuries; Clinical Protocols; Critical Pathways - organization & administration; Emergency Service, Hospital; Female; Fractures, Bone - diagnosis; Fractures, Bone - therapy; Humans; Infant; Male; Medical Audit; Referral and Consultation - organization & administration; Retrospective Studies; Treatment Outcome
• ISSN: 1750-8460
• DOI: 10.12968/hmed.2014.75.5.287

A protocol was devised to address the issue of unnecessary attendance at fracture clinic by children who have a fracture of the clavicle that is deemed to be uncomplicated. For the purposes of this protocol, the clavicle was divided into three zones. Fractures of the middle clavicle for which displacement was minimal, heal quickly in the majority of cases, without the need for follow up. As a result these children can be discharged provided the parents are adequately advised. This article outlines a study which investigated the effectiveness of the protocol. The study found that implementation of the protocol reduced unnecessary attendance at clinic from 85% (47/55) to 17% (4/23). This resulted in cost savings to the trust and reduced the pressure on staff working in busy fracture clinics.