Routine follow-up radiographs for distal radius fractures are seldom clinically substantiated

• Published in: Archives of orthopaedic and trauma surgery Vol. 137; no. 9; pp. 1187 - 1191
• Main Authors: Weil, N. L., El Moumni, M., Rubinstein, S. M., Krijnen, P., Termaat, M. F., Schipper, I. B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2017; Springer Nature B.V
• Subjects: Adult; Clinical decision making; Decision making; Humans; Medicine; Medicine & Public Health; Netherlands - epidemiology; Orthopaedic Surgery; Orthopedics; Radiography; Radius Fractures - diagnostic imaging; Radius Fractures - epidemiology; Radius Fractures - therapy; Retrospective Studies; Treatment Outcome; Distal radius fracture(s); Wrist fracture(s); Radiographs; Imaging; (Routine) radiography
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-017-2743-6

Introduction
The value of routine radiographs during follow-up after distal radius fractures is unclear. The aim of this study was to evaluate whether routine radiographs performed during the follow-up period in patients with a distal radius fracture influenced clinical decision making.
Methods
This retrospective cohort study included patients aged ≥18 years who were treated for a distal radius fracture at four hospitals in The Netherlands in 2012. Demographic and clinical and radiographic characteristics were collected from medical records.
Results
1042 patients were included. In 121 (14%) of the 841 radiographs, a clinical indication was reported. Treatment was affected by 22 (2.6%) radiographs, including 11 (1.5%) radiographs that were categorized as routine, 9 (1.2%) of which led to prolonged cast immobilization and 2 (0.2%) to surgery for conservatively treated patients.
Conclusion
Although it is common practice to take radiographs after distal radius fractures, the study results indicate that routine radiographs seldom affect treatment. This finding should be weighed against the high health care costs associated with these fractures. We hope that the results of our study will trigger the awareness among surgeons that in the current practice, many radiographs are taken on routine without influencing clinical decision making and can probably be omitted.
Level of evidence
Level III.