Routine 6-Week Outpatient Visit in Patients After Osteosynthesis of Lower Extremity Fractures: Is It Truly Necessary?

Background/Objectives: The rising fracture burden has strained healthcare systems, prompting a reassessment of standard practices. One of such practices-the six-week postoperative outpatient visit and X-ray for lower extremity fractures-remains standard, though its value in modern care is increasingly uncertain. Methods: This retrospective study examined patients with the most common lower extremity fractures (including proximal femur, femoral and tibia shaft and bi-/tri-/malleolar fractures) treated surgically at a Level 1 trauma center between January 2020 and March 2024. It focused on two outcomes on the six-week postoperative visit: Firstly, the incidence of radiographic abnormalities on X-rays taken-defined as discrepancies compared to intra- or immediate postoperative images-and their clinical relevance. Secondly, the incidence of deviations from local standard postoperative treatment and follow-up protocols. Abnormalities and deviations were classified as necessitating additional diagnostic tests, further therapeutic interventions, modifications to the standard postoperative regimen-including immobilization, weightbearing status, and permitted range of motion (ROM). Results: A total of 275 patients were included. Deviations from standard care, based on the outpatient visit as a whole, occurred in 9%, rarely requiring reinterventions. Six-week X-rays abnormalities were found in 6%. Of all X-rays, only 2% had a clinical consequence; of those, one patient was asymptomatic. Conclusions: These findings suggest that routine six-week follow-up visits and radiographs after surgical treatment of common lower limb fractures seldom result in changes in clinical management. While the 6-week visit may provide additional value through assessment of functional recovery, rehabilitation guidance, reassurance, and addressing practical concerns, these benefits need to be balanced against the limited clinical yield of routine hospital-based follow-up. These findings therefore raise the question of whether a routine 6-week hospital visit and radiograph are warranted for every patient, and whether alternative models of follow-up, including physiotherapist-led assessment with selective referral to the treating hospital, could provide a more targeted approach.