Opportunities Offered by Telemedicine in the Care of Patients Affected by Fractures and Critical Issues: A Narrative Review

Abstract

Telerehabilitation is an effective, accessible addition or alternative to conventional rehabilitation for fracture management, especially in older adults after hip fractures, leveraging video visits, mHealth apps, virtual reality (VR), and wearable sensors to deliver exercise, education, and monitoring at home with high satisfaction and adherence. Across non-surgical and surgical contexts, telemedicine shows feasibility and cost benefits, with mixed superiority but consistent non-inferiority for functional outcomes versus in-person care. In hip fracture populations, randomized and non-randomized studies indicate improvements in functional independence measure (FIM), Timed Up and Go test (TUG), Activities of Daily Living/Instrumental Activities of Daily Living (ADLs/IADLs), and quality of life, with some evidence for reduced anxiety and depression, while effects on mobility, pain, and adverse events remain uncertain overall. In patients with upper-limb fractures, telerehabilitation appears to improve function and pain, though strength gains may lag compared with in-person therapy in some trials; adjuncts like motor imagery and virtual reality may enhance outcomes and motivation. Application is facilitated by user-friendly platforms, caregiver involvement, and simple modalities such as structured phone follow-up. Limitations include small samples, heterogeneous protocols, scarce long-term data, and a predominance of non-inferiority or complementary designs, warranting larger, definitive trials. This technology can lead to improved patient management at home, effortlessly verifying treatment compliance, efficacy, and safety, while simultaneously reducing the need for hospitalization, promoting a more peaceful recovery. Here, we have undertaken a narrative review of the medical-scientific literature in this field.

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