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CHECK RADIOGRAPHS AFTER DYNAMIC HIP SCREW FIXATIONS. DO WE NEED THEM ROUTINELY?

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

The purpose of this study was to find out whether routine post operative check radiographs after DHS (Dynamic Hip Screw) fixations are contributing to patient management. In a random selection of 50 NHS hospitals in England, 18 orthopaedic units were found to be ordering formal check radiographs after DHS. In our department check radiographs were routinely being done even though image pictures were printed in theatre. We reviewed 174 DHS fixations, assessed adequacy of image intensifier pictures and compared them with post operative radiographs. 115 stable fractures showed no change in position of fracture or screw. In 59 unstable fractures 14 showed medialisation of femoral shaft. 132 case notes were reviewed and none of these patients have had a change in post operative mobilization status based on check radiographs. The 14 unstable fractures which showed change in position too continued with mobilization.

We conclude that routine check radiographs are unnecessary after DHS fixations if adequate image pictures are obtained at surgery. It has important implications like manpower and cost, patient discomfort and unnecessary radiation.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.