Pediatric Fracture Clinics: Current Status and Future Directions

Abstract

The increasing demand for fracture care in pediatric patients, along with the shortage of fellowship-trained pediatric orthopedic surgeons and the growing number of uninsured or under-insured children, places considerable demands on institutions that provide such care. High-volume, multidisciplinary, outpatient fracture clinics can be efficient and cost effective, and can ease the burden on crowded emergency departments. Using a team approach with an orthopedic surgeon and a number of mid-level care providers stream-lines care and makes the most efficient use of the varied skills of these individuals. The fracture-care team may include nurse practitioners, physician assistants, nurse coordinators, orthopedic technicians, physical therapists, radiology technicians and even social services, such as case managers, child-life specialists and translators. Having all of these resources readily accessible provides a ‘one-stop shop’ for pediatric fracture care. This can decrease the number of visits to the emergency department for cast concerns, in turn decreasing the cost of fracture treatment.