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Updated: Feb 6, 2026

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Utility of Routine Postoperative Radiographs After Fixation of Lower Extremity Fractures.

Kevin Phelps1, Michelle Coleman, Rachel Seymour

  • 1From the Carolinas Medical Center, Charlotte, NC (Dr. Phelps, Dr. Seymour, and Dr. Bosse), and Baylor College of Medicine, Houston, TX (Dr. Coleman).

The Journal of the American Academy of Orthopaedic Surgeons
|August 23, 2018
PubMed
Summary
This summary is machine-generated.

Routine radiographs after lower extremity fracture fixation rarely alter management, suggesting opportunities for cost savings by reducing non-essential imaging. This study analyzed 586 fractures to assess the clinical utility of postoperative X-rays.

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Health Economics

Background:

  • Internal fixation of lower extremity fractures often involves serial postoperative radiographs.
  • The clinical utility and cost-effectiveness of these routine imaging studies are not fully understood.

Purpose of the Study:

  • To investigate the clinical utility of radiographs at all time points after internal fixation of lower extremity fractures.
  • To determine the impact of routine postoperative radiographs on changes in patient management.

Main Methods:

  • Retrospective chart review at a level I trauma center.
  • Analysis of 586 fractures (femur, tibia, ankle) in 485 patients.
  • Evaluation of radiographic findings and their effect on management decisions.

Main Results:

  • An average of 4.8 radiographs per fracture were obtained, costing $938,469.
  • Radiographs alone prompted management changes in 31% of fractures with deviations.
  • Most changes (98%) occurred between immediate post-op and fracture union confirmation.

Conclusions:

  • Routine radiographs infrequently alter immediate postoperative management.
  • Radiographs are more likely to influence management during the weight-bearing progression phase.
  • Optimizing imaging protocols can lead to significant cost savings.