title: Primary care in the management of common orthopaedic problems.
abstract: BACKGROUND
  Improving national healthcare services through the enhancement of primary care, is a major challenge in many countries.
  
  
  OBJECTIVE
  To assess the prevalence of those orthopaedic cases that could be managed by a primary healthcare system.
  
  
  METHODS
  Between January 2001 and January 2006 a total of 39 172 patients attended the orthopaedic emergency department (ED) of Laikon University Hospital. All cases were included in this retrospective study. The registry of the orthopaedic ED was analysed by age, sex and clinical diagnosis. All patients were evaluated by a specialist. Classification of the cases was based on the main symptom of those seeking care.
  
  
  RESULTS
  A total of 39 172 patients visited the orthopaedic ED; 17 040 (43.5%) of these patients were stratified in six major groups of diagnosis. Back pain (17.1%) was the most common reason for seeking care in the orthopaedic ED, followed by ankle injuries (10.3%). The admission rate was 1.2%, and X-ray examination was necessary for 93.4% (15 220) of patients.
  
  
  CONCLUSIONS
  This study confirms the widely held view that most cases attending the orthopaedic ED could have been managed by appropriately equipped primary care settings. In this context, the role of general practitioners should be re-appraised and strengthened.
authors.affiliation: General Practice Department, Athens University Medical School, Laiko Hospital, Athens, Greece. marinosgiorgos@hotmail.com
authors.forename: George
authors.initials: G
authors.lastname: Marinos
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: Kostas
authors.initials: K
authors.lastname: Vlasis
authors.forename: Othon
authors.initials: O
authors.lastname: Michail
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsargyris
authors.forename: Siasos
authors.initials: S
authors.lastname: Gerasimos
authors.forename: Gialafos
authors.initials: G
authors.lastname: Elias
authors.forename: Chris
authors.initials: C
authors.lastname: Klonaris
authors.forename: John
authors.initials: J
authors.lastname: Griniatsos
authors.forename: Provlengios
authors.initials: P
authors.lastname: Stefanos
authors.forename: Ioanna
authors.initials: I
authors.lastname: Vasileiou
mesh_terms: D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000628:therapy*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies