The check X-ray: an unnecessary investigation after hip fracture fixation?
An X-ray-based image intensification system is a necessary operative aid in many orthopaedic procedures. Technological advances have not only increased the resolution of these systems, but allow the production of thermal images. We have compared such images obtained at the time of surgery with posto...
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Published in: | Injury Vol. 27; no. 5; pp. 351 - 352 |
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Abstract | An X-ray-based image intensification system is a necessary operative aid in many orthopaedic procedures. Technological advances have not only increased the resolution of these systems, but allow the production of thermal images. We have compared such images obtained at the time of surgery with postoperative radiographs in 80 patients who underwent closed reduction and internal fixation for proximal femoral fractures. The films were independently assessed with particular reference to fracture reduction and the adequacy of fixation. In no case did the postoperative radiograph provide additional information. We therefore suggest that a postoperative radiograph is only necessary in exceptional circumstances. This is of significance in relation to patient discomfort, morbidity and radiation exposure. It also has important financial and manpower implications. |
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AbstractList | An X-ray-based image intensification system is a necessary operative aid in many orthopaedic procedures. Technological advances have not only increased the resolution of these systems, but allow the production of thermal images. We have compared such images obtained at the time of surgery with postoperative radiographs in 80 patients who underwent closed reduction and internal fixation for proximal femoral fractures. The films were independently assessed with particular reference to fracture reduction and the adequacy of fixation. In no case did the postoperative radiograph provide additional information. We therefore suggest that a postoperative radiograph is only necessary in exceptional circumstances. This is of significance in relation to patient discomfort, morbidity and radiation exposure. It also has important financial and manpower implications. |
Author | Haddad, F.S. Williams, R.L. Prendergast, C.M. |
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Cites_doi | 10.1302/0301-620X.74B3.1587871 10.1016/0020-1383(95)00017-4 10.1136/bmj.310.6973.149 10.1302/0301-620X.71B3.2722942 10.1259/0007-1285-66-790-899 10.2106/00004623-198365010-00001 10.1136/bmj.297.6656.1116 10.1302/0301-620X.75B1.8421031 10.1136/bmj.310.6984.904 10.1302/0301-620X.75B3.8496219 |
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Keywords | Performance evaluation Human Postoperative High resolution Radiodiagnosis Diseases of the osteoarticular system Exploration Fracture Trauma Hip Radiography Health economy Thermal image Bone Cost analysis Public health Comparative study |
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References | Sanders, Koval, DiPasquale, Schmelling, Stenzler, Ross (bib16) 1993; 75A Christensen (bib11) 1995; 26 Dwyer (bib6) 1995; 310 Miller, Davis, MacClean, Davis, Smith, Humphries (bib13) 1983; 65A Todd, Freeman, Camilleri-Ferrante, Palmer, Hyder, Laxton, Parker, Payne, Rushton (bib7) 1995; 310 Gilchrist, Newman, Hamblen, Williams (bib8) 1988; 297 Noorden, Lavy, Briggs, Roos (bib12) 1993; 75B Hynes, Conere, Mee, Cashman (bib4) 1992; 74B International Commission on Radiological Protection (bib3) 1991; 60 Goldstone, Wright, Cohen (bib15) 1993; 66 Smith, Lavy, Briggs, Nordeen (bib14) 1992; 74 Fenton Lewis (bib9) 1986; 68B Documents of the National Radiological Protection Board (bib2) 1990; 1 Stoker (bib5) 1993; 75B Pryor, Williams (bib10) 1989; 71B The Health and Safety Executive (bib1) 1985 Fenton Lewis (10.1016/0020-1383(95)00225-1_bib9) 1986; 68B The Health and Safety Executive (10.1016/0020-1383(95)00225-1_bib1) 1985 Pryor (10.1016/0020-1383(95)00225-1_bib10) 1989; 71B Documents of the National Radiological Protection Board (10.1016/0020-1383(95)00225-1_bib2) 1990; 1 Dwyer (10.1016/0020-1383(95)00225-1_bib6) 1995; 310 Hynes (10.1016/0020-1383(95)00225-1_bib4) 1992; 74B Christensen (10.1016/0020-1383(95)00225-1_bib11) 1995; 26 Todd (10.1016/0020-1383(95)00225-1_bib7) 1995; 310 Smith (10.1016/0020-1383(95)00225-1_bib14) 1992; 74 International Commission on Radiological Protection (10.1016/0020-1383(95)00225-1_bib3) 1991; 60 Gilchrist (10.1016/0020-1383(95)00225-1_bib8) 1988; 297 Stoker (10.1016/0020-1383(95)00225-1_bib5) 1993; 75B Noorden (10.1016/0020-1383(95)00225-1_bib12) 1993; 75B Sanders (10.1016/0020-1383(95)00225-1_bib16) 1993; 75A Miller (10.1016/0020-1383(95)00225-1_bib13) 1983; 65A Goldstone (10.1016/0020-1383(95)00225-1_bib15) 1993; 66 |
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publication-title: Ann R Coll Surg Engl contributor: fullname: Nordeen – volume: 310 start-page: 904 year: 1995 ident: bib7 article-title: Differences in mortality after fractures of the hip: the East Anglian audit publication-title: Br Med J contributor: fullname: Rushton – volume: 74B start-page: 332 year: 1992 ident: 10.1016/0020-1383(95)00225-1_bib4 article-title: Ionising radiation and the orthopaedic surgeon publication-title: J Bone Joint Surg [Br] doi: 10.1302/0301-620X.74B3.1587871 contributor: fullname: Hynes – volume: 26 start-page: 331 year: 1995 ident: 10.1016/0020-1383(95)00225-1_bib11 article-title: Are hard copy prints from peroperative fluoroscopy images useful as documentation? publication-title: Injury doi: 10.1016/0020-1383(95)00017-4 contributor: fullname: Christensen – volume: 60 start-page: 1 issue: 21 year: 1991 ident: 10.1016/0020-1383(95)00225-1_bib3 publication-title: The Recommendations of the International Commission on Radiological Protection 1990 contributor: fullname: International Commission on Radiological Protection – volume: 75A start-page: 26 year: 1993 ident: 10.1016/0020-1383(95)00225-1_bib16 article-title: Exposure of the orthopaedic surgeon to radiation publication-title: J Bone Joint Surg [Am] contributor: fullname: Sanders – issue: No. 1333 year: 1985 ident: 10.1016/0020-1383(95)00225-1_bib1 publication-title: The Ionising Radiation Regulations contributor: fullname: The Health and Safety Executive – volume: 1 issue: 3 year: 1990 ident: 10.1016/0020-1383(95)00225-1_bib2 publication-title: Patient Dose Reduction in Diagnostic Radiology contributor: fullname: Documents of the National Radiological Protection Board – volume: 310 start-page: 149 year: 1995 ident: 10.1016/0020-1383(95)00225-1_bib6 article-title: Britain does too many X-rays publication-title: Br Med J doi: 10.1136/bmj.310.6973.149 contributor: fullname: Dwyer – volume: 71B start-page: 471 year: 1989 ident: 10.1016/0020-1383(95)00225-1_bib10 article-title: Rehabilitation after hip fractures publication-title: J Bone Joint Surg [Br] doi: 10.1302/0301-620X.71B3.2722942 contributor: fullname: Pryor – volume: 66 start-page: 899 year: 1993 ident: 10.1016/0020-1383(95)00225-1_bib15 article-title: Radiation exposure to the hands of orthopaedic surgeons during procedures under fluoroscopic X-ray control publication-title: Br J Radiol doi: 10.1259/0007-1285-66-790-899 contributor: fullname: Goldstone – volume: 65A start-page: 1 year: 1983 ident: 10.1016/0020-1383(95)00225-1_bib13 article-title: Radiation exposure and associated risks to operating room personnel during use of fluoroscopic guidance for selected orthopaedic procedures publication-title: J Bone Joint Surg [Am] doi: 10.2106/00004623-198365010-00001 contributor: fullname: Miller – volume: 68B start-page: 15 year: 1986 ident: 10.1016/0020-1383(95)00225-1_bib9 article-title: To what extent is fracture of the femoral neck becoming more common? publication-title: J Bone Joint Surg [Br] contributor: fullname: Fenton Lewis – volume: 297 start-page: 1116 year: 1988 ident: 10.1016/0020-1383(95)00225-1_bib8 article-title: Prospective randomised study of an orthopaedic geriatric inpatient service publication-title: Br Med J doi: 10.1136/bmj.297.6656.1116 contributor: fullname: Gilchrist – volume: 75B start-page: 4 year: 1993 ident: 10.1016/0020-1383(95)00225-1_bib5 article-title: Ionising radiation and the orthopaedic patient publication-title: J Bone Joint Surg [Br] doi: 10.1302/0301-620X.75B1.8421031 contributor: fullname: Stoker – volume: 310 start-page: 904 year: 1995 ident: 10.1016/0020-1383(95)00225-1_bib7 article-title: Differences in mortality after fractures of the hip: the East Anglian audit publication-title: Br Med J doi: 10.1136/bmj.310.6984.904 contributor: fullname: Todd – volume: 74 start-page: 326 year: 1992 ident: 10.1016/0020-1383(95)00225-1_bib14 article-title: Ionising radiation: are orthopaedic surgeons at risk? publication-title: Ann R Coll Surg Engl contributor: fullname: Smith – volume: 75B start-page: 448 year: 1993 ident: 10.1016/0020-1383(95)00225-1_bib12 article-title: Unrecognised joint penetration in treatment of femoral neck fractures publication-title: J Bone Joint Surg [Br] doi: 10.1302/0301-620X.75B3.8496219 contributor: fullname: Noorden |
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SubjectTerms | Biological and medical sciences Bone Screws Fracture Fixation, Internal Hip Fractures - diagnostic imaging Hip Fractures - surgery Humans Injuries of the limb. Injuries of the spine Medical sciences Postoperative Period Radiographic Image Enhancement - economics Traumas. Diseases due to physical agents |
Title | The check X-ray: an unnecessary investigation after hip fracture fixation? |
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