Sharma Vivek, Witney-Lagen Caroline, Cullen Samuel, Kim Edward, Haider Zakir, Davy Anthea, Hunter Alistair
UCL Medical school, University College London, Bloomsbury, London, UK.
University College London Hospital, Bloomsbury, London, UK.
J Hand Surg Asian Pac Vol. 2019 Dec;24(4):435-439. doi: 10.1142/S2424835519500553.
The role of early radiographic imaging in the management of distal radius fractures (DRFs) is unclear. The aim of this study was to assess whether early post-operative radiographs for DRFs influences the ongoing management of this patient group. We hypothesize that routine early radiographs do not influence the management of DRFs. This was a retrospective review of patients undergoing open reduction and internal fixation using a volar locking plate between 2012 and 2017 at our institution. Patients were identified using hospital electronic databases. Clinical information was gathered from the electronic health records and PACS systems and analysed on a spreadsheet. An early post-operative radiograph was defined by the authors as imaging on a patient's first postoperative visit. 237 patients were identified. The median number of days patients were reviewed post-operatively was 13 (interquartile range 9-16). 172 (73.1%) patients had early post-operative radiographs, with 100 (58.1%) intra-articular and 72 (41.9%) extra-articular fractures. Of patients who underwent imaging, 7 (4.0%) had their post-operative fracture management altered (7 intra-articular, 0 extra-articular) with 1 (0.58%) requiring immediate surgical revision as indicated by imaging. Our study questions the value of routine early post-operative radiographs in the management of distal radius fracture fixations, in particular if the fracture is extra-articular. This is of importance in the setting of constrained resources and represents a poor use of limited healthcare facilities, as well as unnecessary radiation exposure.
早期影像学检查在桡骨远端骨折（DRF）治疗中的作用尚不清楚。本研究的目的是评估DRF术后早期X线片是否会影响该患者群体的后续治疗。我们假设常规早期X线片不会影响DRF的治疗。这是一项对2012年至2017年在我院接受掌侧锁定钢板切开复位内固定治疗的患者的回顾性研究。通过医院电子数据库识别患者。从电子健康记录和PACS系统收集临床信息，并在电子表格上进行分析。作者将术后早期X线片定义为患者术后首次就诊时的影像学检查。共识别出237例患者。患者术后接受复查的天数中位数为13天（四分位间距9 - 16天）。172例（73.1%）患者有术后早期X线片，其中关节内骨折100例（58.1%），关节外骨折72例（41.9%）。在接受影像学检查的患者中，7例（4.0%）的术后骨折治疗方案发生了改变（7例关节内骨折，0例关节外骨折），其中1例（0.58%）根据影像学检查结果需要立即进行手术翻修。我们的研究对常规术后早期X线片在桡骨远端骨折固定治疗中的价值提出了质疑，特别是对于关节外骨折。在资源有限的情况下，这一点很重要，这表明有限的医疗设施使用不当，同时也是不必要的辐射暴露。
