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Provision of Video Education Instead of an In-person Visit for Pediatric Buckle Fractures: A Randomized Controlled
Mosufa Zainab1, Mehmet E Kilinc2, Devon R Pekas2
1Virginia Tech Carilion School of Medicine, Roanoke, VA.
Introduction:
Pediatric buckle fractures are common. These are often referred to as orthopaedic surgery offices, despite evidence that specialty evaluation is unnecessary. Here, we sought to determine if the provision of an educational video instead of an in-person visit with an orthopaedic provider would be non-inferior for patient-reported outcomes and demonstrate improvement in other outcomes, such as patient, caregiver, and provider time spent on caring for this injury.
Methods:
This was a single-center, prospective, randomized controlled, non-inferiority trial of 41 patients with distal radius buckle fractures. The video group was emailed a 1.5-minute educational video and did not have any in-person visits with an orthopaedic provider. The in-person group had a standard in-person visit. Patients were followed over 6 weeks. A non-inferiority analysis was performed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Short Form v2.0-Upper Extremity 8a. Other outcome measures were collected for satisfaction, time spent on healthcare activities, missed time from work/school, and provider time spent delivering care.
Results:
Compared with the in-person group, the video group demonstrated a non-inferior PROMIS score improvement from baseline to 6 weeks post-injury. Both groups were overall satisfied with their care, with no statistically significant difference. Patients and caregivers in the video group spent significantly less mean±SD time on healthcare activities aside from learning (video: 59.8±54.1 min vs. in-person: 144.1±95.2 min; P =0.002), had less time missed from work (video: 8.5±27.4 min vs. in-person: 137.1±246.1 min; P =0.006), and less time missed from school (video: 95.1±209.3 min vs. in-person 191.4±259.2 min; P =0.037). In addition, the provider spent significantly less time delivering care for patients in the video group (video: 0.0±0.0 min vs. in-person: 33.7±17.9 min).
Conclusions:
For patients with distal radius buckle fractures, video-based education should be considered as an alternative to an in-person orthopaedic visit.
Level Of Evidence:
Therapeutic Level I.
