Simplified Postoperative Radiographs
Conditions
Brief summary
The standard post-operative radiographic protocol for the monitoring of fractures at HSC includes post-operative in hospital radiographs as well as radiographs at the two week follow up appointment. This is in addition to good quality intra-operative radiographs. With current operative techniques and implants, orthopaedic surgeons can achieve reliably stable internal fixation. In fact, patients are often allowed to take weight through the fractured limb immediately post-operatively. In these cases, redundant post-operative radiographs likely represent an avoidable cost to the system financially, and an avoidable cost to the patient in additional time spent in hospital and unnecessary radiation exposure.
Interventions
OTHERNo-Xray
Treatment group: these patients will not have routine post-operative in hospital radiographs, or radiographs in clinic at two weeks. After examining the patient, the surgeon or resident can order radiographs if required at any time. The decision will be made based on patient complaints of increased pain, appearance of abuse of the splint or cast suggesting lack of compliance or visible clinical deformity of the limb. The reason leading to radiographs will be documented by the ordering physician. If radiographs are ordered based on a wound complication, this will be specifically documented. Radiographic findings will be documented on a form identical to that used for the control group.
OTHERXray
Sponsors
Health Sciences Centre Foundation, Manitoba
University of Manitoba
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Caregiver)
Eligibility
Sex/Gender
ALL
Age
17 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Femur fracture treated with intramedullary nailing * Tibia fracture treated with intramedullary nailing * Ankle fractures treated with standard compression technique * Humeral shaft fractures treated with standard compression technique * Forearm fractures treated with standard compression technique * One or both bones fractured * Simple fracture or presence of single butterfly fragment treated with lag screw * Clavicle fracture treated with standard compression technique * Olecranon fracture treated with standard compression technique
Exclusion criteria
* Age \< 17 years, or open growth plates * Multiple orthopaedic fractures * History of radiographic appearance of osteoporosis or osteopenia or poor operative bone quality * Likely difficult with follow-up in first 6 weeks * Same day surgery case * Surgeon feels patient should be excluded
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| cost-effectiveness of a simplified post-operative radiographic protocol for selected fractures | post-operative day one or two in hospital, as well as in clinic at two and six weeks | Cost-effectiveness will be measured by calculating cost of x-ray, patient care and time spent by patient in clinic. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | At six weeks post-op | Validated Patient Satisfaction Questionnaire to be used to measure patient satisfaction with a simplified post-operative radiographic protocol. |
Countries
Canada
Outcome results
None listed