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Published on: August 17, 2017
No additional value of routine check X-rays after internal fixation of hip fractures
M Westerterp1, M Emous2, M C Vermeulen2
1Department of Surgery, Tergooiziekenhuizen, Van Riebeeckweg 212, 1213 XZ, Hilversum, The Netherlands. mwesterterp@hotmail.com.
Insights
Routine postoperative X-rays after hip fracture surgery are unnecessary and do not change patient management. Eliminating these check X-rays reduces radiation exposure, pain, and healthcare costs for hip fracture patients.
Area of Science:
- Orthopedic surgery
- Radiology
- Healthcare management
Background:
- Hip fractures are a growing concern, particularly in the elderly population.
- Current Dutch hospital practices often include routine postoperative X-rays after hip fracture surgery, despite evidence suggesting their limited utility.
- These routine X-rays contribute to patient discomfort, radiation exposure, and increased healthcare costs.
Purpose of the Study:
- To evaluate the necessity and impact of routine check X-rays performed one day after internal fixation of hip fractures.
- To determine if these X-rays influence postoperative management decisions in patients who received adequate intraoperative image intensifier guidance.
Main Methods:
- A retrospective study analyzed 294 patients who underwent internal fixation for hip fractures between January 2006 and December 2007.
- Data from 254 patients who received a postoperative check X-ray were included for analysis.
Main Results:
- Out of 254 patients who had a check X-ray, only two (less than 1%) experienced a change in their postoperative management based on the X-ray findings.
- This indicates a very low yield for routine check X-rays in this patient cohort.
Conclusions:
- Routine check X-rays following internal fixation of hip fractures, when performed with adequate intraoperative image intensifier guidance, are not clinically useful.
- Discontinuing this practice can lead to significant reductions in radiation exposure, patient pain, and healthcare expenditures.
Purpose:
Annually approximately 18,044 patients are admitted to Dutch hospitals with hip fractures. This is an increasing demand for medical care due to the increasing amount of elderly people. Although previous studies showed that routine check of X-rays following hip fracture surgery is unnecessary, it remains routine in most clinics in the Netherlands. In addition to the radiation exposure to the patient, it is painful and leads to unnecessary costs. This study aims to establish if routine check X-rays 1 day after internal fixation for hip fracture with adequate image intensifier guidance influence postoperative management.
Patients And Methods:
A retrospective study was performed for all patients undergoing internal fixation of hip fractures with image intensifier guidance in the period from January 2006 until December 2007 in our hospital.
Results:
In that period 294 patients underwent internal fixation of hip fractures, 254 underwent a check X-ray and were included in this study. In only two patients the check X-ray did change patient management.
Conclusion:
A check X-ray following internal fixation of hip fractures after adequate peroperative image intensifier guidance is not useful. Dismissing this unuseful medical investigation, leads to less radiation exposure, less pain and less costs.
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