Saving time in the fracture clinic: 2 weeks post-operative plain films following open reduction and internal fixation of
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ORIGINAL ARTICLE
Saving time in the fracture clinic: 2 weeks post-operative plain films following open reduction and internal fixation of distal radius fractures do not affect management Quentin W. A. Jeantet 1
&
Eamonn I. Coveney 1 & Brendan J. O’Daly 1
Received: 25 March 2020 / Accepted: 21 October 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Introduction Distal radius fractures represent up to one in every sixth treated fracture. The majority of these are intra-articular and require operative management. Many recent studies advocate for the use of volar plating fixation. Following fixation, most patients attend the fracture clinic at 2 and 6 weeks post-operatively and may get repeat imaging at both visits, resulting in longer wait times and repeat exposure to radiation. Revision surgery is however rarely performed in the 2- to 6-week period, raising the question of the necessity of plain film at 2 weeks. Aim Improve patient satisfaction in the fracture clinic by reducing wait time in fracture clinic and limiting exposure to radiation. Method The number of distal radius open reduction and internal fixation (ORIF) over a 12-month period was retrieved using theatre logbooks. Patient details were used to check whether a plain film radiograph had been performed 2 weeks post-operatively. Subsequently, patients’ records were used to determine if revision surgery was performed or planned. Results In total, 123 distal radius ORIF were performed between January 2018 and January 2019. Two-week check radiographs were performed for 82 patients (67%). One patient (0.8%) underwent revision surgery following review of intra-operative imaging. No patients underwent revision ORIF following 2-week plain film. Conclusion Repeat imaging at 2 weeks following distal radius ORIF did not change management of distal radius fractures in this study. Therefore, our data suggests 2-week plain films should not routinely be ordered for these patients which will reduce wait time and exposure to radiation. Keywords Distal radius fracture . Management . Open reduction internal fixation . Post-operative radiographs
Introduction Distal radius fractures (DRF) are amongst the most common orthopaedic injuries encountered in clinical practice, accounting for up to 15% of fractures in adults [1, 2]. The estimated lifetime risk of sustaining a DRF is 15% in women and 2% in men [3, 4]. The incidence rate of DRF is 190–200 per 100,000 population per year [5]. DRF have a bimodal distribution, with high-energy trauma in the under 25-year-old population and low-energy trauma in the
* Quentin W. A. Jeantet [email protected] 1
Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin 24, Republic of Ireland
elderly population, either from a fall on outstretched hand or osteoporotic fragility fracture [1, 3]. Depending on the fracture pattern, DRF can be managed conservatively with cast immobilisation or operatively, with manipulation and casting, manipulation and Kirschner wire fixation, open reduction and inter
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