Routine radiography following ankle fracture fixation: a case for limiting its use.
The use of fluoroscopic screening in the orthopaedic theatre is a necessary operative aid in many procedures. Modern systems give good image resolution and allow the production of per-operative hard-copy prints. This study was performed to compare these prints with postoperative radiographs in 41 patients who underwent internal fixation for an ankle fracture in a 6-month period. The hard-copy prints and the postoperative X-ray films were independently assessed for several features, which included status of the tibiofibular syndesmosis, fibular length, talo-crural angle, talar tilt, presence and size of a posterior malleolar fracture, and abnormality of the medial clear space. Information was also recorded as to whether there had been a change in postoperative management plan after review of the check X-ray. Of the 41 cases, 30 were suitable for full assessment. In 25 of these cases there was no difference in the information provided by the hard-copy prints from fluoroscopic images and the postoperative check X-rays. In the other five cases, the differences were not significant. In none of the cases did the check X-ray effect a change in postoperative management. We therefore suggest that if per-operative hard-copy prints are obtained from the fluoroscopic images, postoperative radiographs of the ankle are only necessary in exceptional circumstances.
Harish
S
S
Department of Orthopaedics, Norfolk and Norwich Hospital, UK.
Vince
A S
AS
Patel
A D
AD
D000328:Adult; D000368:Aged; D017046:Cost Savings; D005471:Fluoroscopy / Q000191:economics / Q000592:standards; D005593:Fracture Fixation, Internal / Q000191:economics; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000191:economics / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011829:Radiation Dosage; D011859:Radiography / Q000191:economics / Q000706:statistics & numerical data; D013639:Tarsal Bones / Q000000981:diagnostic imaging* / Q000293:injuries