Session VIII - General Interest

Sat., 10/12/13 Topics of General Interest, PAPER #96, 1:45 pm OTA 2013

Are Routine 2-Week Postoperative Radiographs Useful?

Brian Mosier1; Gregory T. Altman, MD1, Lisa Taitsman, MD2;
1Department of Orthopaedic Surgery, Allegheny General Hospital,
Pittsburgh, Pennsylvania, USA;
2Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, Washington, USA

Purpose: The purpose of this study is to evaluate the utility of early postoperative radiographs in the management of patients with surgically stabilized lower extremity fractures.

Methods: In a retrospective manner we collected 320 patients treated surgically for fractures involving the femur, tibia, and/or fibula by a single orthopaedic traumatologist. Routine practice at our facility is to follow up with surgery patients at approximately 2 weeks, 6 to 8 weeks, and 3 months postoperatively. If patients underwent staged management, then the 2-week follow point considered was after the final surgery. Medical records and radiographs were reviewed for all patients.

Results: Over a 5-year period, 320 patients with 344 fractures involving the femur, tibia, and/or fibula underwent surgical repair of their fracture. There were 162 men and 158 women. The average age was 42 years (range, 18-95 years). The average follow-up period for all 344 fractures was 110 days. Of the 344 fractures, 309 were radiographed at 2 weeks. There were 28 patients (35 fractures) who did not have 2-week radiographs secondary to being an inpatient or did not follow up at the 2-week interval. Of these 28 patients, none required any additional surgical interventions. Of the 309 fractures that had radiographs at 2 weeks, 246 fractures in 233 patients were followed for 3 months or greater duration. Four fractures required subsequent intervention at less than 3 months. All four interventions consisted of surgical irrigation and débridement of wound infections with removal of the exposed hardware. In our study no fracture required revision fixation as a result of the 2-week postoperative radiographs. In addition, no patient had a change in mobilization, weight bearing, or range of motion activities as the result of the 2-week radiographs.

Conclusion: The routine use of radiographic examination at the 2-week postoperative visit has limited utility.

Alphabetical Disclosure Listing

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.