Do check X-rays influence the management of patients who have undergone hip fracture fixation using image intensifier guidance?

Cooney, Alan; Campbell, AC

doi:10.1016/j.injury.2005.12.019

Cited by 27 publications

(20 citation statements)

References 4 publications

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“…Doyle et al reported that the anteroposterior view rarely added significant information when taking follow‐up views of anterior cervical plating and that its elimination could reduce expenses if a single projection was excluded and also lead to a reduction in radiation exposure to the patient. Furthermore, Cooney and Campbell reported potential savings in the UK as none of the patients in their study had their management changed following the post‐operative hip x‐ray exam. Therefore exclusion of the post‐operative hip x‐ray exam should be considered when applying the principles of justification.…”

Section: Benefits Of Justificationmentioning

confidence: 99%

“…Considering the practice of justification is based on the application of evidence‐based research, justification should encourage critical thinking. This allows for the development of new practices and protocols, benefiting patients in the future …”

Section: Benefits Of Justificationmentioning

confidence: 99%

“…This allows for the development of new practices and protocols, benefiting patients in the future. 17,51 Evidence-Based Practice (EBP) and Justification…”

Section: Benefits Of Justificationmentioning

confidence: 99%

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Justification of radiographic examinations: What are the key issues?

Vom

Williams

2017

J Med Radiat Sci

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Justification of radiographic examinations is the practice of evaluating requested radiological examinations to assess for clinical merit and appropriateness based on clinical notes and patient information. This implies that justification in radiography requires the evaluation of requested examinations, the justification of exposures being applied and determining whether patients fit the recommended criteria for the procedure. Medico‐legal requirements by the professional registration body, the Medical Radiation Practice Board of Australia (MRPBA), identify justification as an advocated and obligatory practice for radiographers. Yet, justification remains an inconsistent practice implemented amongst Australian radiographers. This review aims to identify associated barriers inhibiting the consistent practice of justification and the hesitance by radiographers in practicing justification responsibilities. It also recommends a change in workplace culture which encourages radiographers to accept a more autonomous role that cultivates critical thinking, reflection and research‐informed decision making as justification will ultimately benefit patients.

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Section: Benefits Of Justificationmentioning

confidence: 99%

Section: Benefits Of Justificationmentioning

confidence: 99%

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Justification of radiographic examinations: What are the key issues?

Vom

Williams

2017

J Med Radiat Sci

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“…Studies regarding the utility of EPI as part of the patient follow-up after internal fixation of a wide range of fractures, including proximal femur fractures, are scarce [ 5 – 9 , 24 ]. Although the use of IMN for IFF has become the work-horse in this field, the main modality of treatment addressed in the previous literature was DHS, with no sufficient data on IMNs.…”

Section: Discussionmentioning

confidence: 99%

“…While the value of EPI for other fracture fixations was previously questioned by Canadian researchers [ 3 ], we found lack of prospectively investigated data regarding EPI of patients with IFF that were operated by IMN. A few studies from the USA and Europe that dealt with the value of EPI in IFF [ 5 – 9 ] did reflect an international eager to limit the execution of these radiographs but have included mainly patients that were operated with DHS and hemiarthroplasties and only few IMN patients, the current work-horse in this field. Evidence-based data is therefore needed in order to allow surgeons worldwide to plan the proper imaging protocol for IMN patients.…”

Section: Introductionmentioning

confidence: 99%

Routine early post-operative X-ray following internal fixation of intertrochanteric femoral fractures is unjustified: a quality improvement study

et al. 2018

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BackgroundThere is no consensus regarding the proper radiographic protocol following closed or open reduction and internal fixation for intertrochanteric femoral fractures. The objective of this study was to assess the role of early postoperative imaging studies when deciding about weight bear limitations and reoperations.MethodsA prospective cohort study of 100 patients (26 men and 74 women, at a mean age of 79.8 years) treated by closed or open reduction and internal fixation for AO31A fractures was conducted. According to the AO classification, there were 25 cases of 31A1, 54 cases of 31A2, and 21 cases of 31A3. For every patient, the intraoperative fluoroscopy studies were recorded and post-operative radiograms were taken during the first week. Excluded were patients for whom the early X-rays were clinically indicated. The intraoperative AP and axial fluoroscopy studies were compared with the radiograms taken during the first post-operative week. The investigators compared the decisions regarding weight-bearing limitations and the need for re-operation before and after conducting the radiograms.ResultsThe early post-operative imaging studies did not change weight-bearing limitations nor did they lead to consecutive surgical treatments.ConclusionsUnless indicated by physical examination, there is no value to routine post-operative radiograms within the first few days after closed reduction and internal fixation of intertrochanteric femoral fractures with regard to weight-bearing limitations and re-operation decisions.Trial registrationIdentifier: NCT02868125.

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