External Fixator Usage and Delayed MRI Scans: A National Survey Study.

Area of Science:

• Orthopaedic Surgery
• Radiology
• Medical Device Safety

Background:

• External fixation devices (EFDs) are crucial for managing complex fractures.
• Magnetic Resonance Imaging (MRI) provides superior soft tissue visualization but poses compatibility challenges with EFDs.
• Current institutional protocols for MRI use in patients with EFDs are not well-defined.

Purpose of the Study:

• To assess the current landscape of institutional protocols for MRI use in patients with EFDs across the United States.
• To identify barriers and challenges encountered by orthopaedic surgeons when ordering MRIs for patients with EFDs.
• To determine the perceived need for national guidelines regarding MRI and EFD compatibility.

Main Methods:

• A national survey was conducted among practicing orthopaedic surgeons.
• Participants were recruited via the Orthopaedic Trauma Association website.
• Survey data analyzed to evaluate current practices, complications, and perceived barriers.

Main Results:

• No harmful complications from MRI use with EFDs were reported.
• 13% of respondents reported scan terminations due to minor warmth or vibration.
• 90% reported delays in care due to MRI-EFD compatibility labeling, with 48% experiencing delays for every patient needing an MRI.
• 42% of surgeons modified their practice, and 89% believed national guidelines are necessary.

Conclusions:

• MRI utilization in patients with EFDs is frequently hindered by compatibility concerns, despite a lack of reported complications.
• Existing institutional protocols have not effectively mitigated delays in care.
• Further national-level research and consensus guidelines are essential to address this widespread issue.