AB122. Saving time in the fracture clinic: an audit of follow up radiographs at 2 weeks following open reduction and internal fixation of distal radius

Background: Distal radius fractures are one of the most common type of orthopaedic injuries, representing one in every sixth treated fracture. Up to 50% of these fractures are intra-articular and require operative management. Many recent studies advocate the use of volar plating to fix those fractures. Currently, most patients attend fracture clinic at 2- and 6-week post operatively and get repeat imaging at both visits resulting in long wait times at each visit and repeat exposure to radiation. Revision open reduction and internal fixation (ORIF) is however rarely performed after 2 weeks, raising the question of the necessity of plain film at 2-week.

Methods: Theatre logbooks were used to obtain the number of distal radius ORIF performed over a 6 months period. Patient details were then used to check if a check X-ray was performed at 2-week post op. Patients’ records were then checked to assess if a revision surgery was performed or planned.

Results: A total of 123 distal radius ORIF were performed between January 2018 and January 2019. A 2-week check radiograph was performed for 43 of these (64%). One patient underwent a revision surgery following review of intraoperative imaging. No patients underwent revision ORIF following 2-week X-ray.

Conclusions: Repeat imaging at 2-week following distal radius ORIF does not change management of these fractures. Therefore, 2-week repeat X-ray should not routinely be ordered for these patients which will reduce wait time and exposure to radiation.

Keywords: Distal radius fractures; open reduction and internal fixation; post-operative management