Telemedicine and orthopaedic care. A review of 2 years of experience.

The objective of this study was to study the delivery of orthopaedic care via a telemedicine network. This study is a descriptive analysis of orthopaedic teleconsultations done during a 2-year period by three orthopaedic surgeons. Four hundred ten teleconsultations were done during the study period from February 1, 1995, to December 31, 1996. Orthopaedic surgeons engaged in 91 teleconsultations (22% of all teleconsultations). Reasons for orthopaedic teleconsultations were: evaluation and treatment of fracture care (39 cases; 43%); evaluation and treatment of ligamentous injury, joint swelling and infection (32 cases; 35%); postoperative evaluation (16 cases; 18%); and evaluation and treatment of dislocations (four cases; 4%). Sixty-two (68%) of the patients remained in the rural community. Twenty-one (23%) of the orthopaedic teleconsultations were classified as emergent (done immediately). Thirty-five (38%) were urgent (done within 1 to 2 hours of provider request), and 35 (38%) were scheduled. The mean duration of time for teleconsultations was 12.8 minutes. Eighty-seven (96%) of the teleconsultations occurred Monday through Friday. Outcome data were collected on all patients involved in teleconsultations. No adverse patient outcomes occurred. This study suggests telemedicine may be an avenue for the delivery of orthopaedic care to patients residing in areas where orthopaedic specialists are not available.

Skin tests for chymopapain allergy.

Skin prick tests with therapeutic chymopapain (CP) solution, 10 mg/mL, were administered prior to CP injection. Three of 232 (1%) of patients with negative skin tests and 5/6 (83%) of patients with positive skin tests reacted to the therapeutic injection of CP. A positive CP skin test is a contraindication to therapeutic CP injection.