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Is there a need for standardized postoperative X-rays after operative treatment of clavicular fractures?

Abstract

Purpose

In most hospitals, acquiring postoperative X-rays after operative treatment of a fracture is the standard. Its value, however, after operative treatment for clavicular fractures is questionable. The aim of this study was to evaluate how often there is a change in treatment plan due to the postoperative X-ray after operative treatment of clavicular fractures when intra-operative images were acquired.

Methods

This was a retrospective cohort study performed in a level I trauma center. All consecutive patients treated surgically for clavicular fractures between 2014 and 2018 were included. The primary outcome was any deviation from the standard postoperative protocol resulting from the routine postoperative X-ray taken within the first 72 h after surgery. Secondary outcomes included all other complications and re-interventions performed during follow-up of patients with at least 6-month follow-up.

Results

In total, 241 patients were included in the study with a mean age of 42 years (SD 17). Only one patient had an abnormality on postoperative X-ray necessitating additional CT-scanning. No additional re-interventions or deviations from standard postoperative protocol were required.

For secondary analyses, 187 patients were available. Seven patients had a late implant associated infection: one was detected at the time of implant removal and six during revision for non-union. Six patients had aseptic complications: four with non-union and two with implant failure. One-hundred and seven patients had an implant removal due to irritation after consolidation.

Conclusion

Routinely performing postoperative X-rays after osteosynthesis for clavicular fractures seems unnecessary. Refraining from performing unnecessary radiographs will decrease exposure to radiation and likely have a beneficial effect on costs, length of hospital stay as well as healthcare consumption. This study was performed in a single center; therefore, it remains to be seen whether the findings are reproducible in another setting.

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Fig. 1

Data availability

Data are available and will be provided if needed.

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Funding

There was no external source of funding for this study.

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Correspondence to Isabelle R. Buenter.

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Conflict of interest

Isabelle R. Buenter, Valerie Kremo, Philipp Schelber, Nicole M. van Veelen, Nadine Diwersi, Matthias Knobe, BC Link, Reto Babst, Frank JP Beeres, Bryan J.M. van de Wall declare that they have no conflict of interest.

Informed consent

There was no informed consent requested in this trial. No personal or confidential data were included in this analysis.

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Buenter, I.R., Kremo, V., Schelbert, P. et al. Is there a need for standardized postoperative X-rays after operative treatment of clavicular fractures?. Eur J Trauma Emerg Surg (2021). https://doi.org/10.1007/s00068-021-01802-0

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Keywords

  • Clavicular fracture
  • Clavicle fractures
  • Postoperative X-ray
  • Postoperative radiograph
  • Treatment plan change