title: Ankle radiographs in the early postoperative period: do they matter?
abstract: OBJECTIVE
  To evaluate the utility of postoperative ankle radiographs via a comparison of complication rates among patients who had ankle radiographs in the early postoperative period versus those who obtained radiographs in a delayed fashion.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Urban level I trauma center.
  
  
  METHODS
  Approximately 1411 patients who underwent surgical fixation of an ankle fracture between 2001 and 2010 who received postoperative ankle radiographs in postoperative days 7-120.
  
  
  METHODS
  Patients were identified using a current procedural terminology search and were divided between 2 groups based on the timing of the first postoperative ankle radiograph. Each chart was reviewed for complications.
  
  
  METHODS
  The rate of complications for patients with early postoperative ankle radiographs (7-21 days) was compared with those of patients with late postoperative radiographs (22-120 days) using χ and Fisher exact tests.
  
  
  RESULTS
  Approximately 889 patients were included in the early group and 522 patients were in the late group. Overall, 93 patients with complications were identified (6.59%): 62 patients (6.97%) in the early group and 31 patients (5.93%) in the late group. The results showed no statistically significant difference in the rate of complications between the early and late groups.
  
  
  CONCLUSIONS
  There is insufficient evidence to suggest that complication rates following ankle fracture fixation differ by the timing of postoperative radiographs. This investigation questions the justification of routine radiographs of operatively treated ankle fractures.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *School of Medicine, Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Nashville, TN; Deptartments of †Anesthesiology, and ‡Orthopaedics & Rehabilitation; Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Nashville, TN.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: McDonald
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bulka
authors.forename: Rachel V
authors.initials: RV
authors.lastname: Thakore
authors.forename: William T
authors.initials: WT
authors.lastname: Obremskey
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Ehrenfeld
authors.forename: A Alex
authors.initials: AA
authors.lastname: Jahangir
authors.forename: Manish K
authors.initials: MK
authors.lastname: Sethi
mesh_terms: D000328:Adult; D064386:Ankle Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult