Telesurveillance: Exploring the Use of Mobile Phone Imaging in the Follow-Up of Orthopedic Patients with Hand Trauma

Background: Intra-articular phalangeal fractures involving the proximal interphalangeal joint (PIPJ) are notoriously difficult injuries to treat and often require regular follow-up to assess progress, guide treatment, and determine outcomes. Some patients often have to travel long distances for follow-up care. The aim of our study was to assess the clinical outcomes of intra-articular fractures of the PIPJ through use of clinical pictures sent through a mobile phone. Methods: A retrospective study was conducted of a consecutive group of patients treated with a static external fixator (Micro Hoffman-2 Stryker (R)) between 2006 and 2016 for an intra-articular fracture of the PIPJ. Range of motion (ROM) at the PIPJ was assessed through clinical pictures taken on a mobile phone. Results: Clinical images were received from 15 patients with a mean age of 31.9 years (range 15-51), of which 73.3% of patients were male. Mean length of follow-up was 39 months. Around 73.3% of injuries occurred while playing a sport. Mean PIPJ ROM assessed through the clinical images was 67 degrees. Conclusion: Our study shows that it was possible to assess ROM at the PIPJ through the use of clinical pictures taken by mobile phone. The use of mobile phones to take images provided a simple, easy, and convenient means of assessing outcome in this cohort of patients. We describe a method of follow-up that may have a greater role in the future.