Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Pl, Box 1188, New York, NY, 10029, USA.
Emerg Radiol. 2020 Apr;27(2):191-193. doi: 10.1007/s10140-019-01746-4. Epub 2019 Dec 13.
The purpose of this study is to determine the clinical utility of second-physician review of radiographs obtained after reduction of distal radius and ankle fractures.
Fifty consecutive ankle and distal radius fractures requiring reduction were reviewed. The time from post-reduction radiograph to second-physician interpretation was obtained. The second-physicians' interpretation was evaluated for clinically influential information. Patients requiring a repeat reduction were identified, and the timing of the repeat reduction radiograph was compared with the timing of the second-physician interpretation of the initial post-reduction radiograph.
The mean time of second-physician interpretation for post reduction ankle radiographs was 6 h and 47 min (range 4 min to 43 h and 3 min). Eleven of 50 (22%) interpretations of post reduction ankle radiographs commented on acceptability of reduction. The mean time of second-physician interpretation for post reduction distal radius radiographs was 5 h and 34 min (range 8 min to 22 h and 59 min). Seven of 50 (14%) interpretations of post reduction distal radius radiographs commented on acceptability of reduction. Three distal radius (6%) and 8 ankle fractures (16%) required repeat reduction. Repeat reductions were completed in 10/11 cases (91%) before the second-physician review of the initial post reduction radiograph was obtained. In only 1 case of repeat reduction was the second-physician review of the post reduction radiograph available before repeat reduction was attempted.
The timing and quality of second-physician review of post-reduction radiographs offers little utility to the clinical management of ankle and distal radius fractures.
本研究旨在确定对桡骨远端和踝关节骨折复位后获得的 X 光片进行二次阅片的临床实用性。
回顾了 50 例连续的需要复位的踝关节和桡骨远端骨折患者。获得了从复位后 X 光片到二次阅片的时间。评估了二次阅片医师对有临床影响的信息的解释。确定了需要再次复位的患者，并比较了初始复位后 X 光片的二次阅片时间与再次复位 X 光片的时间。
踝关节复位后 X 光片的二次阅片平均时间为 6 小时 47 分钟（范围为 4 分钟至 43 小时 3 分钟）。11 例（22%）踝关节复位后 X 光片的解释对复位的可接受性进行了评价。桡骨远端复位后 X 光片的二次阅片平均时间为 5 小时 34 分钟（范围为 8 分钟至 22 小时 59 分钟）。7 例（14%）桡骨远端复位后 X 光片的解释对复位的可接受性进行了评价。3 例（6%）桡骨远端和 8 例（16%）踝关节骨折需要再次复位。在获得初始复位后 X 光片的二次阅片之前，11 例中的 10 例（91%）完成了 11 例中的 3 例（6%）桡骨远端和 8 例（16%）踝关节骨折的再次复位。在尝试再次复位之前，只有 1 例再次复位的患者可获得复位后 X 光片的二次阅片。
对复位后 X 光片进行二次阅片的时间和质量对踝关节和桡骨远端骨折的临床处理几乎没有帮助。
