Little radiographic change seen in the first 3 months after intramedullary nailing

Issue: April 2017

SAN DIEGO — Patients who underwent intramedullary nailing had little radiographic change within the first 3 months after surgery, according to results presented here.

“There may be little utility to retain postoperative radiographs within the first 3 months after surgery in the absence of new clinical concerns that shows new trauma, infection or malalignment,” Robert D. Wojahn, MD, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

Robert D. Wojahn

Wojahn and colleagues evaluated postoperative radiographs of 185 patients (76% were men) who underwent intramedullary nailing to determine the Radiographic Union Score for Tibial fractures (RUST) and to assess implant integrity. Researchers included 774 postoperative radiographs, with 92% collected within 1 year after surgery and 2% collected 2 years or more from the initial surgery.

Results showed the 5th percentile and median time for any healing was 33 days and 78 days after surgery, respectively. Wojahn noted the 5th percentile and median time for what investigators considered healed was 84 days and 182 days after surgery, respectively; while complete healing for those ranges was 176 days and 355 days after surgery, respectively.

“Little healing was observed within the first 6 [weeks] to 8 weeks after surgery, which is at a time when many postoperative radiographs are currently being taken,” he said.

According to Wojahn, 11 patients had broken interlocked screws at a median of 251 days out from surgery. Of these patients, six required additional surgery. Early reoperation also occurred among five patients within the first 90 days postoperatively. – by Casey Tingle

Reference:

Abraamyan T, et al. Paper #201. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 14-18, 2017; San Diego, Calif.

Disclosure: Wojahn reports no relevant financial disclosures.