Eliminating Routine Post-Operative Radiographs for Surgically-Managed Paediatric Supracondylar Humerus Fractures

Description

This presentation by Mark Camp discusses a study aimed at assessing the impact of follow-up radiographs on the management of pediatric supracondylar humerus fractures that were found to be stable during surgery. The study evaluated the standard post-operative pathway for these fractures at an institution, which typically involves a follow-up visit at three weeks for clinical assessment and radiographic evaluation. Clinicians were instructed to document their management plans before assessing the X-rays, allowing for comparison in treatment decisions based on radiographic findings.



A total of 623 patients were recruited, with a final analysis including 483 cases. The findings indicated that only 0.6% of patients required changes in management based on the follow-up X-rays, suggesting minimal utility of routine post-operative imaging for stable type II and III fractures. Furthermore, significant findings from the research led to the removal of routine post-operative radiographs from the care pathway for the mentioned fracture types, with the aim of reducing unnecessary healthcare burdens without compromising patient care.



Camp also emphasizes that missed injuries are critical concerns in pediatric trauma surgery, highlighting the importance of focused imaging strategies that only include X-rays likely to influence management. Additionally, future steps involve evaluating the real-world implications of the adjusted imaging protocols and assessing the necessity of follow-up visits post pin removal for patients.

DOI: 10.1302/3114-240562

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