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.

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.