Title : Do routine postoperative radiographs influence the management of distal radius fractures following volar locking plate fixation
Abstract:
Background: Distal Radius Fractures (DRFs) are among the most common orthopaedic injuries and frequently require surgical fixation using volar locking plates. Routine postoperative radiographs are commonly obtained following surgery to assess fixation and identify early complications; however, their impact on clinical management remains uncertain. This study evaluated whether routine postoperative radiographs influence management decisions following volar locking plate fixation of DRFs.
Methods: A retrospective review was conducted of 176 patients who underwent open reduction and internal fixation of distal radius fractures using volar locking plates at a UK district general hospital over a two-year period. Patient demographics, fracture characteristics, postoperative imaging findings, and subsequent management changes were collected and analysed. The primary outcome measure was the rate of reoperation resulting from new findings identified on routine postoperative radiographs. Secondary outcomes included any alteration in postoperative management based on imaging findings.
Results: Routine postoperative radiographs were obtained in all patients. Only one patient (1%) required reoperation based on new radiographic findings identified postoperatively. Approximately 8% of patients experienced a change in management, primarily involving prolonged cast immobilisation. No significant additional complications requiring urgent intervention were identified solely through routine imaging. The findings suggest that routine postoperative radiographs rarely altered clinical decision-making following uncomplicated volar locking plate fixation of DRFs.
Conclusions: Routine postoperative radiographs following volar locking plate fixation of distal radius fractures appear to have limited influence on patient management and reoperation rates. Their routine use may contribute to unnecessary healthcare costs and avoidable radiation exposure. A more selective, case-by-case imaging approach based on fracture complexity, associated injuries, and clinical indications may optimise resource utilisation without compromising patient care.
