Telemedical extremity boards and quality assessment of guidelines for orthoplastic surgery of openfractures of the extremities

Kampshoff DE; Khosh MK; Roßlenbroich J; Raschke MJ; Hirsch T; Roßlenbroich S

Abstract

Open fractures of the lower extremities are an interdisciplinary challenge that demands not only expertise in trauma and plastic-reconstructive surgery, but also specialised knowledge in vascular surgery, infectious diseases, radiology, and microbiology. However, despite the high morbidity and substantial healthcare costs, there are currently no established interdisciplinary guidelines for managing these injuries in Germany.This review discusses important aspects of orthoplastic treatment strategies and explores the role of telemedical extremity boards in optimising these treatment processes, as demonstrated by the EXPERT innovation fund project at Münster University Hospital. Furthermore, the quality of existing international guidelines is assessed using the British Orthopaedic Association Standard for Trauma (BOAST) (4 guidelines) as an example.With ongoing hospital reforms and the shift toward centralised specialized services, cross-sector digital care models are gaining importance. Establishing interdisciplinary standards, guidelines, and structured communication through telemedicine is key to maintaining the highest quality of care for open fractures and in mitigating the loss of expertise in peripheral regions.