Abstract
Intra-operative fluoroscopic screening is common practice in trauma surgery, as an operative guide and to assess the final fixation. However, often patients return to the ward and are sent for a further ‘check x-ray’ in the subsequent post-operative period.
Our aims were to evaluate the use of post-op ‘check x-rays’ in our hospital, and determine whether they had any influence on the management or outcomes for our trauma patients. Between December 2010 and June 2011, our study population included all patients who had intra-operative fluoroscopic images for trauma fixation surgery at Grantham and District Hospital. We then reviewed whether they had an additional x-ray taken in the post-operative period. Finally we assessed their subsequent fracture clinic follow-up images to determine whether there were any complications that had arisen. There were 108 patients who had intra-operative films, with a mean age of 59.7 years (17 to 98). Of these, 44% of patients had an additional x-ray in the post-operative period. There was a wide variability in practice between the various types of fixations (e.g. Hip, Humerus, Ankle, etc). At follow-up, all x-rays were satisfactory and there were no complications. The post-operative x-ray did not alter the management or outcome for any of our patients. There is no need for a ‘routine post-op check x-ray’ for patients who have had an adequate intra-operative film. Subjecting patients to additional x-rays causes them discomfort, delayed discharged, increased radiation exposure and has significant financial implications. Other similar studies support our results, and a post-operative film should only be requested if clinically indicated or in exceptional circumstances.
