Increased Efficiency With Use of a Mini C-Arm in Emergency Department Closed Reductions

Area of Science:

• Orthopaedic Surgery
• Emergency Medicine
• Radiology

Background:

• Closed reductions for distal radius and ankle fractures traditionally rely on post-reduction radiographs.
• Concerns exist regarding patient radiation exposure and procedural efficiency with traditional methods.

Purpose of the Study:

• To evaluate the impact of mini C-arm imaging versus traditional radiographs on emergency department (ED) efficiency.
• To assess changes in patient radiation exposure and the frequency of repeat closed reductions for fracture management.

Main Methods:

• Retrospective chart review of adult patients with isolated distal radius or ankle fractures requiring closed reduction.
• Comparison of outcomes between patients managed with mini C-arm imaging and those with traditional post-reduction radiographs.
• Key metrics included total radiation exposure, repeat reduction rates, orthopaedic consult time, and ED length of stay.

Main Results:

• Mini C-arm use was associated with significantly lower total radiation exposure (0.4 mGy vs 0.9 mGy) and closed reduction radiation exposure (0.1 mGy vs 0.5 mGy).
• Fewer repeat reductions were required in the mini C-arm group (0 vs 65), with a significant reduction in time from doctor visit to discharge (3.8 hours vs 6.2 hours).
• Orthopaedic consult time and time under sedation were also significantly shorter with mini C-arm use.

Conclusions:

• The mini C-arm is a valuable tool for improving emergency department efficiency in managing distal radius and ankle fractures.
• Utilizing a mini C-arm leads to decreased patient radiation exposure and a reduced need for repeat closed reductions.
• This imaging modality enhances patient care by streamlining the fracture reduction process.