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. 2017 Sep;137(9):1187-1191.
doi: 10.1007/s00402-017-2743-6. Epub 2017 Jul 22.

Routine follow-up radiographs for distal radius fractures are seldom clinically substantiated

N L Weil  1 , M El Moumni  2 , S M Rubinstein  3 , P Krijnen  4 , M F Termaat  4 , I B Schipper  4
Affiliations

Routine follow-up radiographs for distal radius fractures are seldom clinically substantiated

N L Weil et al. Arch Orthop Trauma Surg. 2017 Sep.

Abstract

Introduction: The value of routine radiographs during follow-up after distal radius fractures is unclear. The aim of this study was to evaluate whether routine radiographs performed during the follow-up period in patients with a distal radius fracture influenced clinical decision making.

Methods: This retrospective cohort study included patients aged ≥18 years who were treated for a distal radius fracture at four hospitals in The Netherlands in 2012. Demographic and clinical and radiographic characteristics were collected from medical records.

Results: 1042 patients were included. In 121 (14%) of the 841 radiographs, a clinical indication was reported. Treatment was affected by 22 (2.6%) radiographs, including 11 (1.5%) radiographs that were categorized as routine, 9 (1.2%) of which led to prolonged cast immobilization and 2 (0.2%) to surgery for conservatively treated patients.

Conclusion: Although it is common practice to take radiographs after distal radius fractures, the study results indicate that routine radiographs seldom affect treatment. This finding should be weighed against the high health care costs associated with these fractures. We hope that the results of our study will trigger the awareness among surgeons that in the current practice, many radiographs are taken on routine without influencing clinical decision making and can probably be omitted.

Level of evidence: Level III.

Keywords: (Routine) radiography; Distal radius fracture(s); Imaging; Radiographs; Wrist fracture(s).

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

One author of this study (MFT) received a grant from The Netherlands Organisation for Health Research and Development (ZonMw 837002403) for “Is routine radiography following the initial 2-week follow-up of trauma patients with wrist and ankle fractures necessary?” These funds were used to pay NLW’s salary.

Ethical statement

Our investigation complies with the current laws and ethical standards of The Netherlands. All data are stored in accordance with Dutch privacy legislation.

Figures

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References

    1. CBS StatLine—Medisch Specialistische Zorg; DBC’s naar diagnose (detail) (2016) [Online]. Available: http://statline.cbs.nl/Statweb/publication/?DM=SLNL&PA=82470ned&D1=2&D2=.... Accessed 7 Nov 2016
    1. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691–697. doi: 10.1016/j.injury.2006.04.130. - DOI - PubMed
    1. Karl JW, Olson PR, Rosenwasser MP. The epidemiology of upper extremity fractures in the United States. J Orthop Trauma. 2009;29(8):e242–e244. doi: 10.1097/BOT.0000000000000312. - DOI - PubMed
    1. Ghattas TN, Dart BR, Pollock AG, Hinkin S, Pham A, Jones TL. Effect of initial postoperative visit radiographs on treatment plans. J Bone Joint Surg Am. 2013;95(9):e57, S1. doi: 10.2106/JBJS.K.01670. - DOI - PubMed
    1. Schipper IB, van der Meulen H, Rhemrev S, Bartlema K, van de Bremer J, van der Linden F (2013) Richtlijn voor behandeling van Letsels van het steun-en bewegingsapparaat. [Online]. Available: https://www.lumc.nl/sub/9075/att/130226020734411.pdf. Accessed 7 Nov 2016

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