Abstract
Background There is currently no standard of care for imaging after hand and upper-extremity
procedures, and current imaging practices have not been characterized.
Questions/Purposes To characterize current imaging practices and to compare those practices to the best
available evidence.
Patients and Methods A survey was distributed to attending-level surgeons at a regional hand and upper-extremity
surgery conference in the United States in 2013. 40 out of 75 surgeons completed the
survey (53%).
Results All results are presented for distal radius and scaphoid fractures, respectively.
There was a high degree of variability between respondents in the number of radiographic
series routinely ordered during follow-up of asymptomatic patients, with the number
of series ranging from 1–6 and 1–6. On average, respondents did not order an excessive
number of follow-up radiographs for asymptomatic patients, with means (± standard
deviations) of 2.6 ± 1.0 and 3.3 ± 1.2 radiographic series. Radiographic series were
taken at only 74% and 81% of postoperative visits with asymptomatic patients. Only
10% and 8% of respondents felt it was acceptable medical practice to save costs by
ordering postoperative radiographs only when patients are symptomatic.
Conclusions Among a sample of 40 fellowship-trained hand surgeons, these findings demonstrate
a high degree of variability in number of radiographs obtained after operative repair
of distal radius and scaphoid fractures. On average, respondents were relatively efficient
with respect to total number of postoperative radiographs ordered.
Level of Evidence Diagnostic study, level IV.
Keywords
distal radius fracture - scaphoid fracture - scaphoid stability - internal fixation
- wrist - postoperative radiography
