A Prospective Trial Comparing the Cost of Post Operative X-rays for Fractures Treated With Stable Internal Fixation

Pilot Study for a Randomized Control Trial Comparing the Cost of a Simplified Post-Operative Radiographic (SPOR) Protocol for Fractures With Stable Internal Fixation Treated at Health Sciences Centre

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.

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