Orthopaedic Care During COVID-19: Utilization of Telemedicine in Orthopaedic Surgery During the COVID-19 Pandemic

A Review of Elbow Examination and Assessment

Khaled M. Emara, MD, FEBOT, FRCS, MS; Ramy Ahmed Diab, MD; Ahmed Abdelsalam, MSc; Mostafa Gemeah, MBBCh; Ahmed K. Emara, MD


Curr Orthop Pract. 2021;32(6):544-548. 

In This Article

Abstract and Introduction


The recent Coronavirus Disease 2019 (COVID-19) pandemic made social distancing vital to limiting the spread of infection. As a result many patients postponed their hospital and orthopaedic clinic visits for the fear of contracting the virus, which in turn led to serious complications caused by negligence and lack of follow-up in elbow patients. The pandemic has been an ongoing threat; therefore, establishing an effective virtual assessment technique for patient follow-up has become a valuable option. The authors conducted a systematic approach for proper virtual assessment of patients with elbow disorders using telemedicine.


On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease 2019 (COVID-19) to be a pandemic, with over 33 million cases as of September 29, 2020, and mortality rates of approximately 5% in the general population, more than 10% in people over 60 yr old, and higher in older age groups.[1] As a highly infectious virus many patients postponed clinic and hospital visits for the fear of contracting the virus, which in turn led to serious complications of other issues from negligence.

As a response to the COVID-19 pandemic, telemedicine, which is the use of technology to provide clinical health care, was a vital and valuable option.[2] Telemedicine has many advantages because it is a feasible, accessible, fast, and effective way to provide health care despite geographic and time boundaries. It also has a reduced cost, which can improve a patient's quality of life.[3] There are many obstacles and challenges in using telemedicine because technology is not readily accessible in developing nations. Moreover, some steps in clinical examination are not applicable without an actual physical examination, which can be crucial in reaching a diagnosis.[4]

Orthopaedic surgery is one of the most demanding specialties and can require an early diagnosis to reach a proper decision that avoids complications and achieves the best results. In addition, it also requires continuous follow-up for both postoperative patients and also those who have conservative treatment. Utilizing telemedicine can be a perfect option during a pandemic to improve a patient's quality of life.

Elbow examination and assessment is one of the most applicable regions to be assessed through telemedicine. Physicians can analyze patients' complaints and reach a proper diagnosis through three main items: a detailed history, patient assessment through inspection and special tests, and proper investigations that aid in reaching an appropriate diagnosis.

In this review, the authors elaborated the role of telemedicine in assessment of various elbow pathologies through systematic virtual elbow assessment. The authors note that in case of emergencies and inability to reach a definitive diagnosis, a face-to-face consultation with a physician cannot be replaced.