Utilization of postoperative radiographs following operative fixation of distal radius fractures.

Background: Recent studies show that routine postoperative films after open reduction and internal fixation (ORIF) for distal radius fractures (DRF) rarely alter clinical management. This population-study evaluates the utilization of postoperative radiographs after DRF fixation. Methods: We studied insurance claims from the Truven Marketscan databases to identify patients 18 and older who underwent ORIF for a DRF between 2009 and 2011. Two-years of postoperative data were collected to determine the number and timing of postoperative radiographs, and related clinical events including complications and reoperation. We also compared outcomes between cohorts who received and did not receive radiographs on the day of surgery. Results: We identified 20,041 patients who underwent ORIF for a DRF. Patients received an average of 3.8 +/- 2.1 radiographs during the 2-year follow-up, with 3.0 +/- 1.4 occurring within the first 3 months; 59%, 81%, and 91% of patients did not receive further imaging after 3, 6, and 12 months postoperatively, respectively. Radiographs were obtained on the day of surgery in 47% patients (N=9,372), and these patients received more radiographs overall in the postoperative period (4.4 vs. 3.2). Early reoperation rates (within 14 days) following DRF between patients who did and did not receive same-day radiographs were 5% versus 3%. Conclusions: On average, patients received 4 radiographs following ORIF for a closed DRF. Nearly 50% of individuals received radiographs on the day of surgery, despite low rates of reoperation in the early postoperative period. An evidence-based approach to postoperative radiographs has the potential to reduce DRF-related healthcare utilization. (C)2016American Society of Plastic Surgeons

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