"Fracture clinic - more time needed"
About: Airedale General Hospital / Trauma and orthopaedics Airedale General Hospital Trauma and orthopaedics BD20 6TD
Posted by stray (as ),
I recently attended fracture clinic expecting to be given the all clear after seven weeks in a cast following a broken ankle.
Unfortunately the x-rays showed that the bone has not joined back together. I was put back in a splint and told I will return in another six weeks to see whether it has healed at that stage.
I understand that fracture clinic is extremely busy, and that the volume of patients is determined largely by how many people happened to have attended A&E with fracture type injuries in the previous days.
However, the process "your ankle hasn't healed, see you in six weeks to have another look... off you go and get another cast/boot sorted" lasts about 2 minutes (at most). I was shocked, but didn't have time within the consultation to even think of any questions, let alone ask them.
I would suggest that maybe where patients are being told that actually there is a problem with their healing, they are offered the option to come back with questions once they've had their new cast fitted.
The majority of the time in which I was 'in the consultation' I was sitting alone in the exam room while the Dr taught a med student in the office next door. I could hear just enough of the conversation to know what was happening and I would have much preferred to be present, being talked with, rather than being talked about. After all, it is my leg.
I've been left with many questions and worries. Fortunately my GP is very good and I know she will help me to get those questions answered, but this seems like a very inefficient way to do things - my GP is extremely busy already. It is also unsatisfactory for the patient in terms of experience - it made me feel as though I was being treated as 'the slow healing fibula' rather than a person who has a broken fibula and is being affected a great deal.
I'm self employed, live in a very remote village with no public transport, have some sheep, and normally do a lot of exercise to help control my diabetes and asthma - not having a clear prognosis now that the '4-6 weeks in a cast and then a couple of weeks getting used to walking again' has turned out to be wrong is very worrying. The doctor also didn't explore with me any possible causes for the non-union. Having researched it online, I fear that the fracture probably isn't as 'stable' as was initially assumed - which is an indicator that fixation might be required to get a faster, better repair. He had clearly assumed that I would 'prefer' the more conservative approach of wait-and-see-for-a-while-longer, but I think this decision should have been discussed with me.
I appreciate that fracture clinic is at times extremely busy, but cutting corners on communication with patients is not efficient - for the patient, the Dr concerned (who will now have to field a call from my GP) or the rest of the NHS - not only is it taking up my GPs time but I feel inclined to get my care transferred to a less paternalistic hospital.