- 期刊
Telemedicine with the Mobile Camera-phone in Metacarpal and Phalangeal Fracture
使用照相手機在指骨和掌骨骨折的遠距電子照會應用
摘要
本文目的在於評估使用照相手機來傳送指骨和掌骨骨折X光片影像及進行線上溝通之遠距電子照會之可行性。急診值班住院醫師和照會整形外科醫師之間使用了內建十一萬畫素數位相機及六萬五千色彩色螢幕的Panasonic照相手機來對四十九個病患的六十處指骨和掌骨骨折進行電子照會。照會醫師在遠距照會時和之後的現場評估中對於骨折之辨認及治療建議做出判斷並提供意見來做為比較。之後，三位不同之整形外科醫師對於傳送之影像品質及根據此電子照會訊息所產生之臨床意見及治療建議填寫調查問卷。結果顯示，五十八處骨折(97%)能從此六十處骨折之遠距電子照會中被辨認出來，而且有五十六處骨折(93%)使用遠距電子照會能做出和現場評估後相同的治療建議。遠距電子照會能夠對於大部分案例有關骨折之辨認以及開刀或不開刀的治療建議做出和現場評估後相同之意見。三位不同之整形外科醫師也認為此傳送之影像的品質可堪做為判讀之依據，並且可以對於五十六處骨折(93%)之辨認及四十三處骨折(71%)之治療建議做出一致性之相同意見。本研究顯示使用照相手機對指骨和掌骨骨折進行電子照會是可行及有用的。此種電子照會系統擁有容易使用、低成本、高度可攜性及移動性的優點。伴隨著數位影像及通訊傳輸科技的進步，照相手機在未來遠距電子照會之臨床應用擁有極大之潛力。
關鍵字
無資料並列摘要
The purpose of the present study was to evaluate the feasibility of telemedicine using a mobile camera-phone to transfer radiographic images and on line communication for the diagnosis and treatment recommendations of metacarpal and phalangeal fractures. Teleconsultations were carried out between surgical residents in the emergency room and the consultant surgeon on 49 patients for 60 suspected metacarpal and phalangeal bone fractures by using Panasonic mobile camera-phones, which had a built-in 110,000-pixel digital camera and a 65,536 colors display. Separate fracture identification and treatment recommendations during remote teleconsultation and on-site inspection by the consultant surgeon were performed and compared. Later, a standard questionnaire about the level of satisfaction regarding image resolution and the ability to generate clinical opinions and management recommendations was filled out by three individual plastic surgeons. Of the 60 fractures, 58 fractures (97%) were recognized during the remote teleconsultation and 56 fractures (93%) were managed as per the remote treatment recommendations. Identification of fractures and treatment recommendations of nonoperation or operative fixation made from the remote teleconsultation mostly agreed with evaluations made on-site. In the image analysis conducted by three plastic surgeons, image quality was sufficient for interpretation. The same conclusions were reached in the identification of 56 fractures (93%) and in the treatment planning of 43 (71%) fractures. The results demonstrated that the telemedicine with a mobile camera-phone is feasible and useful for remote metacarpal and phalangeal fracture diagnosis and treatment recommendations. This system has the advantages of ease of use, low cost, and high portability and mobility. There is significant promise in the future for application of telemedicine and telecare with the further advancement of available technology in image media and electronic data transfer.