Do we need standardized postoperative radiographs after locking plate fixation of distal radius fractures - A retrospective analysis of 664 patients

Arch Orthop Trauma Surg. 2024 Dec 12;145(1):28. doi: 10.1007/s00402-024-05631-9.

Abstract

Introduction: After surgical treatment of fractures of the distal radius, radiographs in 2 planes are routinely performed postoperatively as a standard procedure to verify anatomic reduction and implant positioning. However, the postoperative radiological examinations rarely has a consequence. Therefore, the purpose of this study was to evaluate the frequency of treatment plan changes based on standardized postoperative radiographs. Secondarily, abnormalities, already being present in the intraoperative radiographs, were examined.

Methods: Between 2015 and 2019 a total of 664 consecutive patients who underwent open reduction and internal fixation of a distal radius were evaluated in a retrospective study.

Results: The median age was 60 (range 92 - 16 years). Overall, a treatment plan change was detected in 20 patients. After standardized postoperative radiographs a CT scan was performed in 16 patients and 14 patients underwent early operative revision; in only four of these cases, the revision could be attributed to the postoperative radiograph.

Conclusion: Considering the low incidence of treatment plan changes, routinely performed radiographs after surgical treatment of distal radius fractures must be critically questioned.

Keywords: Distal radius fracture; Postoperative radiograph; Radiation.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Aged
  • Aged, 80 and over
  • Bone Plates*
  • Female
  • Fracture Fixation, Internal* / methods
  • Humans
  • Male
  • Middle Aged
  • Radiography*
  • Radius Fractures* / diagnostic imaging
  • Radius Fractures* / surgery
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Wrist Fractures