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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.