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Radial head fractures likely being over-treated
By recommending frequent radiographic follow-up without modifying treatment, orthopedic surgeons are likely over-treating patients with Mason-Johnson type-I radial head fractures, leading to unnecessary patient visits, radiation exposure and increased costs, according to researchers.
The researchers reviewed 82 patients with closed fracture of the radial head or neck, recording complications and treatment interventions, in addition to collecting demographic, radiographic and physical examination data for all patients treated nonoperatively. The researchers analyzed the data to determine whether there were any associations with recommendation for continued follow-up and radiographic assessment.
Results showed 68% of patients had 56 nondisplaced or minimally displaced radial head or neck fractures without an additional injury to the affected limb. All of the patients were treated nonoperatively, and no complications or medical or surgical interventions, other than physical therapy, developed in this cohort, according to the researchers.
No radiographic or physical examination measure was significantly associated with recommendation for the second outpatient follow-up, third outpatient follow-up or with the number of additional radiographs ordered beyond the initial examination.
After initial outpatient presentation, the researchers found an average of 4.4 additional X-rays were taken of each affected elbow. – by Casey Tingle
Disclosures: Shulman reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.