Routine Imaging after Operatively Repaired Distal Radius and Scaphoid Fractures: A Survey of Hand Surgeons

 

 Buy Article Permissions and Reprints

Abstract

Background There is currently no standard of care for imaging after hand and upper-extremity procedures, and current imaging practices have not been characterized.

Questions/Purposes To characterize current imaging practices and to compare those practices to the best available evidence.

Patients and Methods A survey was distributed to attending-level surgeons at a regional hand and upper-extremity surgery conference in the United States in 2013. 40 out of 75 surgeons completed the survey (53%).

Results All results are presented for distal radius and scaphoid fractures, respectively. There was a high degree of variability between respondents in the number of radiographic series routinely ordered during follow-up of asymptomatic patients, with the number of series ranging from 1–6 and 1–6. On average, respondents did not order an excessive number of follow-up radiographs for asymptomatic patients, with means (± standard deviations) of 2.6 ± 1.0 and 3.3 ± 1.2 radiographic series. Radiographic series were taken at only 74% and 81% of postoperative visits with asymptomatic patients. Only 10% and 8% of respondents felt it was acceptable medical practice to save costs by ordering postoperative radiographs only when patients are symptomatic.

Conclusions Among a sample of 40 fellowship-trained hand surgeons, these findings demonstrate a high degree of variability in number of radiographs obtained after operative repair of distal radius and scaphoid fractures. On average, respondents were relatively efficient with respect to total number of postoperative radiographs ordered.

Level of Evidence Diagnostic study, level IV.

• References

• 1 Iglehart JK. The new era of medical imaging—progress and pitfalls. N Engl J Med 2006; 354 (26) 2822-2828
  CrossrefPubMedGoogle Scholar
• 2 Bohl DD, Gruskay JA, Miller CP , et al. Recovery room radiographs not found to have incremental utility above intraoperative images after lumbar fusion procedures. Spine 2013; 38 (22) 1927-1933
  CrossrefPubMedGoogle Scholar
• 3 Ndu A, Jegede K, Bohl DD, Keggi K, Grauer JN. Recovery room radiographs after total hip arthroplasty: tradition vs utility?. J Arthroplasty 2012; 27 (6) 1051-1056
  CrossrefPubMedGoogle Scholar
• 4 Christensen M, Folkmar K. No clinical value of post-operative routine X-ray following uncomplicated cementless primary total hip arthroplasty. Dan Med J 2013; 60 (4) A4613
  PubMedGoogle Scholar
• 5 Ghattas TN, Dart BR, Pollock AG, Hinkin S, Pham A, Jones TL. Effect of initial postoperative visit radiographs on treatment plans. J Bone Joint Surg Am 2013; 95 (9) e571-e574 , S1
  CrossrefPubMedGoogle Scholar
• 6 Yamashita T, Steinmetz MP, Lieberman IH, Modic MT, Mroz TE. The utility of repeated postoperative radiographs after lumbar instrumented fusion for degenerative lumbar spine. Spine 2011; 36 (23) 1955-1960
  CrossrefPubMedGoogle Scholar
• 7 Chaudhry S, DelSole EM, Egol KA. Post-splinting radiographs of minimally displaced fractures: good medicine or medicolegal protection?. J Bone Joint Surg Am 2012; 94 (17) e128
  PubMedGoogle Scholar
• 8 Bohl DD, Hustedt JW, Blizzard DJ, Badrinath R, Grauer JN. Routine imaging for anterior cervical decompression and fusion procedures: a survey study establishing current practice patterns. Orthopedics 2012; 35 (7) e1068-e1072
  CrossrefPubMedGoogle Scholar
• 9 Bohl DD, Ruiz FK, Webb ML, Gruskay JA, Grauer JN. Routine imaging for elective lumbar spine surgery: a questionnaire study. Spine 2013; 38 (14) 1233-1237
  CrossrefPubMedGoogle Scholar