The check X-ray: an unnecessary investigation after hip fracture fixation?

An X-ray-based image intensification system is a necessary operative aid in many orthopaedic procedures. Technological advances have not only increased the resolution of these systems, but allow the production of thermal images. We have compared such images obtained at the time of surgery with postoperative radiographs in 80 patients who underwent closed reduction and internal fixation for proximal femoral fractures. The films were independently assessed with particular reference to fracture reduction and the adequacy of fixation. In no case did the postoperative radiograph provide additional information. We therefore suggest that a postoperative radiograph is only necessary in exceptional circumstances. This is of significance in relation to patient discomfort, morbidity and radiation exposure. It also has important financial and manpower implications.