The check X-ray: an unnecessary investigation after hip fracture fixation?

Haddad, Fares S.; Williams, Richard L.; Prendergast, C M

doi:10.1016/0020-1383(95)00225-1

Cited by 33 publications

(16 citation statements)

References 10 publications

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“…These studies are consistent with other orthopedic studies examining routine postoperative radiographs after total knee arthroplasty, total hip arthroplasty, fixation of femur fractures, and spinal arthrodeses (351)(352)(353)(354)(355)(356)(357)(358)(359). We identified no study in the orthopedic literature that purported that the potential benefits of routine radiographic assessment in the absence of a specific clinical indication (i.e., identifying a complication that would result in a change in management) outweigh the risks (primarily cost and cumulative radiation exposure) (347,(358)(359)(360).…”

Section: Postoperative Considerationssupporting

confidence: 87%

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

Meyr

Mirmiran

Naldo

et al. 2017

The Journal of Foot and Ankle Surgery

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A wide range of factors contribute to the complexity of the management plan for an individual patient, and it is the surgeon's responsibility to consider the clinical variables and to guide the patient through the perioperative period. In an effort to address a number of important variables, the American College of Foot and Ankle Surgeons convened a panel of experts to derive a clinical consensus statement to address selected issues associated with the perioperative management of foot and ankle surgical patients.

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Section: Postoperative Considerationssupporting

confidence: 87%

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

Meyr

Mirmiran

Naldo

et al. 2017

The Journal of Foot and Ankle Surgery

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“…[12][13][14][15] For example, a study by Haddad et al 12 demonstrated that postoperative x-rays following operative fixation of hip fractures should only be obtained when clinically indicated and not part of standard treatment. [12][13][14][15] For example, a study by Haddad et al 12 demonstrated that postoperative x-rays following operative fixation of hip fractures should only be obtained when clinically indicated and not part of standard treatment.…”

Section: Discussionmentioning

confidence: 99%

Ankle Radiographs in the Early Postoperative Period

McDonald

Bulka²,

Thakore

et al. 2014

Journal of Orthopaedic Trauma

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“…weight‐bearing status). Many studies have been undertaken to assess the validity of the postoperative radiograph and most stress their use only if clinically indicated (3–5) However, almost all studies restrict themselves to DHS and CS fixation. We include the hemiarthroplasty group as they constitute a large number of hip fracture surgeries and are not normally followed up.…”

Section: Discussionmentioning

confidence: 99%

“… Previous studies have been undertaken to assess the validity of the postoperative radiograph and most stress their use only if clinically indicated (3–5). …”

Section: What's Knownmentioning

confidence: 99%

Postoperative radiographs following hip fracture surgery. Do they influence patient management?

Chakravarthy¹,

Mangat²,

Qureshi³

et al. 2007

International Journal of Clinical Practice

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There is still much debate on the appropriateness of taking postoperative radiographs following hip fracture surgery. In our unit, it is routine practice to request postoperative radiographs after hip hemiarthroplasty but not after internal fixation. An audit conducted in our unit highlighted the low acute implant-related complications. This prompted us to conduct a national audit on current UK practice regarding the use of check radiographs following hip fracture surgery. Retrospective case note review of all patients undergoing hip fracture surgery at our hospital, from 2002 to 2004, was performed. Patients undergoing revision surgery in the same admission were identified to determine whether check radiograph influenced the decision. Subsequently a postal performa was sent to 450 randomly chosen UK Orthopaedic Consultants. The performa was designed to determine practice relating to postoperative radiographs. It also attempted to determine whether postoperative radiographs (when requested) influenced the subsequent clinical management of the patient. A total of 1265 hip fractures treated surgically were reviewed locally. Average length of stay was 29.5 days. There were five acute implant-related complications. One revision was performed for a long hip screw which was obvious on the intra-operative image intensifier films. Only one decision to revise (because of incongruous reduction of a hip hemiarthroplasty) was based on a problem identified on a routine check radiograph. All patients undergoing revision were clinically symptomatic. We received 300 responses. Ninety-six per cent routinely took postoperative radiographs following hip hemiarthroplasty of which 83% allowed the patient to mobilise before checking the radiograph. Following dynamic hip screw (DHS)/dynamic condylar screw (DCS) fixation, 61% took check radiographs of which 75% allowed the patient to mobilise prior to reviewing the radiograph. Following cannulated screw (CS) fixation, 58% routinely performed check radiographs of which 67% allowed the patient to mobilise before reviewing the radiograph. The study highlights the lack of national consensus on the use of postoperative radiographs. We recommend that following DHS/DCS fixation and CS fixation, the use of postoperative radiographs should only be undertaken when clinically indicated. Postoperative radiographs following hip hemiarthroplasty should only be undertaken if there are operative concerns or postoperative complications.

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The check X-ray: an unnecessary investigation after hip fracture fixation?

Cited by 33 publications

References 10 publications

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

Ankle Radiographs in the Early Postoperative Period

Postoperative radiographs following hip fracture surgery. Do they influence patient management?

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