title: Does early radiography alter remanipulation rates in paediatric forearm fractures?
abstract: BACKGROUND
  In paediatric patients with a forearm fracture, treated with manipulation under anaesthesia with fluoroscopic guidance, protocol varies whether a day 1 post-operative radiograph is performed. The primary aim of this study is to evaluate whether this investigation changes the management of a patient. Secondary aims evaluated number of reinterventions and factors associated with loss of position.
  
  
  METHODS
  A retrospective study design was used. Cases were identified from the Wellington Regional Hospital radiology database between 1 January 2010 and 30 July 2011. Ethical approval was obtained for this study.
  
  
  RESULTS
  During the study period, 148 patients under 18 years old presented with a forearm fracture; after exclusion criteria were applied, 107 fractures were included. Sixty-five fractures were evaluated with a day 1 post-operative radiograph; no reinterventions were performed as a result of this investigation. Evaluating the total study population (107), only four reinterventions were performed. No reintervention was performed earlier than 1 week. All patients who required reintervention were investigated with a day 1 post-operative radiograph. No statistically significant associations were found between patient demographic, injury or treatment factors and need for reintervention (at any stage).
  
  
  CONCLUSIONS
  The day 1 post-operative radiograph does not influence management, and cannot be justified given the further cost for hospitals, unnecessary radiation and additional time required.
authors: Department of Orthopaedic Surgery, Christchurch Public Hospital, Christchurch, New Zealand.
authors: Gareth
authors: G
authors: Rooke
authors: Fred T S
authors: FT
authors: Phillips
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D020380:Needs Assessment; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*
keywords: bone; forearm injuries; fractures; orthopaedics; paediatrics; radiography