title: Lateral Radiograph of the Hip in Fracture Neck of Femur: Is it a Ritual?
abstract: BACKGROUND
  Historically routine work up of a patient with a fracture neck of femur has always included an antero-posterior (AP) and a lateral view of the hip. The aim of the study was to know whether a lateral view of hip influenced the decision of an Orthopedic Surgeon regarding management at a District General Hospital.
  
  
  METHODS
  A prospective study was conducted from February 2005 to September 2005 at Tameside General Hospital. X-rays of patients admitted with fracture neck of femur were shown to two independent observers in the daily trauma meeting. AP view of the hip was shown initially to observers and their classification and intended treatment was recorded. They were asked if they needed a lateral view to decide on management option and answers were recorded. The observers were then showed a lateral view of same hip and asked to comment on quality of film and also whether it would change their classification or intended management.
  
  
  RESULTS
  There were 100 patients over six months. On AP view 56 were classified to have extra-capsular fracture, 37 were classified as displaced subcapital fracture and seven were classified undisplaced subcapital fracture. There was an interobserver variation in one patient between undisplaced or displaced subcapital fracture. The observers felt they would need a lateral X-ray on three occasions and there was a change in classification from undisplaced subcapital to displaced subcapital fracture on first occasion. There was no change in management plan in all the 100 patients after looking at a lateral X-ray.
  
  
  CONCLUSIONS
  We can conclude that unless required for management a lateral X-ray of hip should be avoided routinely in all patients with fracture neck of femur as it would not only be cost effective but will also reduce radiation exposure to patient and relieve work pressure on radiographers, nursing and portering staff.
authors.affiliation: Trauma and Orthopaedics, Princess Alexandra Hospital, Marlow, Essex, UK. sujaykd@yahoo.com.|Trauma and Orthopaedics, Basildon University Hospital, Flat 31, Fobbing Farm Close, SS16 5NP, Basildon, Essex, UK. sujaykd@yahoo.com.
authors.forename: Dheerendra S
authors.initials: DS
authors.lastname: Kumar
authors.affiliation: Trauma and Orthopaedics, Arrowe Park Hospital, Wirral, UK.
authors.forename: Shivarathre D
authors.initials: SD
authors.lastname: Gubbi
authors.affiliation: Trauma and Orthopaedics, Tameside General Hospital, Ashton-under Lyne, UK.
authors.forename: Bari
authors.initials: B
authors.lastname: Abdul
authors.affiliation: Trauma and Orthopaedics, Tameside General Hospital, Ashton-under Lyne, UK.
authors.forename: Muddu
authors.initials: M
authors.lastname: Bisalahalli
keywords: Fractures; Fractures of the proximal femur; Orthopedic trauma