No additional value of routine check X-rays after internal fixation of hip fractures
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ORIGINAL ARTICLE
No additional value of routine check X-rays after internal fixation of hip fractures M. Westerterp • M. Emous • M. C. Vermeulen J. P. Eerenberg • A. A. W. van Geloven
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Received: 17 June 2012 / Accepted: 12 December 2012 / Published online: 1 March 2013 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Purpose Annually approximately 18,044 patients are admitted to Dutch hospitals with hip fractures. This is an increasing demand for medical care due to the increasing amount of elderly people. Although previous studies showed that routine check of X-rays following hip fracture surgery is unnecessary, it remains routine in most clinics in the Netherlands. In addition to the radiation exposure to the patient, it is painful and leads to unnecessary costs. This study aims to establish if routine check X-rays 1 day after internal fixation for hip fracture with adequate image intensifier guidance influence postoperative management. Patients and methods A retrospective study was performed for all patients undergoing internal fixation of hip fractures with image intensifier guidance in the period from January 2006 until December 2007 in our hospital. Results In that period 294 patients underwent internal fixation of hip fractures, 254 underwent a check X-ray and were included in this study. In only two patients the check X-ray did change patient management. Conclusion A check X-ray following internal fixation of hip fractures after adequate peroperative image intensifier guidance is not useful. Dismissing this unuseful medical investigation, leads to less radiation exposure, less pain and less costs.
M. Westerterp (&) M. Emous M. C. Vermeulen J. P. Eerenberg A. A. W. van Geloven Department of Surgery, Tergooiziekenhuizen, Van Riebeeckweg 212, 1213 XZ Hilversum, The Netherlands e-mail: [email protected]
Keywords intensifier
Hip fracture Surgery Check X-ray Image
Introduction Fracture of the neck of the femur is the most common fracture in the elderly, and as population ages, this number is rising [1]. Previous studies have suggested that routine postoperative radiographs after internal fixation for hip fractures with image intensifier guidance are unnecessary, unless there is a clinical indication [2–7]. Nevertheless, in most hospitals in the Netherlands it remains routine practice to request this postoperative check of X-rays. Therefore, we conducted this retrospective study in a high number of patients to establish if routine check X-rays 1 day after internal fixation for hip fracture with adequate image intensifier guidance influence postoperative management.
Patients and methods A retrospective study was performed for consecutive patients undergoing internal fixation of hip fractures using image intensifier guidance (GE Medical Systems, OEC 9800 Plus) over the 2 years from January 2006 to December 2007. The operative procedures are summarized in Table 1. Only those patients who had a check X-ray on postoperative day 1 were included. From these patients the case notes were examin
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