Do Routine Postoperative Radiographs Influence the Management of Distal Radius Fractures Following Volar Locking...

Area of Science:

• Orthopaedic surgery
• Radiology
• Health economics

Background:

• Distal radius fractures (DRFs) are common orthopaedic injuries requiring surgical intervention.
• Postoperative radiographs are standard after DRF fixation but their necessity is debated.
• Evaluating the impact of routine radiographs on DRF management is crucial.

Purpose of the Study:

• To assess the necessity of routine postoperative radiographs in managing distal radius fractures (DRFs) treated with volar locking plates.
• To determine if routine radiographs influence reoperation rates or management changes.

Main Methods:

• A retrospective review of 176 patients undergoing open reduction and internal fixation for DRFs with volar locking plates.
• Collected data included demographics, fracture details, postoperative imaging findings, and management alterations.
• Primary outcome: reoperation rate based on new radiographic findings.

Main Results:

• Only 1% of patients required reoperation due to findings on routine postoperative radiographs.
• Approximately 8% of patients had management changes, such as prolonged cast immobilization.
• The majority of routine postoperative radiographs revealed no significant new findings impacting care.

Conclusions:

• Routine postoperative radiographs for DRFs treated with volar locking plates have minimal impact on management decisions.
• Overutilization of these radiographs increases healthcare costs and radiation exposure.
• A case-by-case approach, considering clinical factors, is recommended to optimize radiograph use for distal radius fractures.