Do check X-rays influence the management of patients who have undergone hip fracture fixation using image intensifier guidance?

Abstract

To determine if postoperative check X-rays influence the management of patients who have undergone hip fracture fixation using image intensifier guidance and the possible economic impact. A fractured neck of femur is the commonest fracture sustained in the UK amongst the elderly population, with internal fixation commonly carried out under image intensifier guidance, producing high quality intraoperative images. In the postoperative period, patients often receive a subsequent check X-ray, although recent evidence has suggested little additional information is gained. We examined the X-rays of 100 patients who underwent internal fixation (using image intensifier guidance) for a fractured neck of femur. Twenty-four patients received a postoperative check X-ray, although none of these patients had their management altered by this subsequent X-ray. If these check X-rays are avoided, there is a potential saving of over 2000 sterling pound in our hospital and 38,800 sterling pound in Scotland per annum.