Routine follow-up imaging is not necessary in uneventful early recovery after distal radius fractures treated with volar locking plate in working-aged patients: A retrospective single-center cohort study
Background and objective: The purpose of our study was to evaluate whether routine follow-up radiographs after distal radius fracture (DRF) treated with volar locking plate (VLP) influenced clinical decision-making and treatment in working-aged patients (18–65 years). We evaluated the possible corre...
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| Veröffentlicht in: | Scandinavian journal of surgery 2024-09, Vol.113 (3), p.189-196 |
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| creator | Kärnä, Laura Launonen, Antti P. Luokkala, Toni Reito, Aleksi |
| description | Background and objective:
The purpose of our study was to evaluate whether routine follow-up radiographs after distal radius fracture (DRF) treated with volar locking plate (VLP) influenced clinical decision-making and treatment in working-aged patients (18–65 years). We evaluated the possible correlation between clinical status and problems with follow-up radiographs and analyzed the overall reoperation rate.
Methods:
The study population of this retrospective cohort study consisted of working-aged (18–65 years) patients with DRF who were treated with VLP between January 2010 and December 2020. Baseline data, follow-up visits, and radiographs were collected. Radiographs were classified as either routinely assigned or according to clinical findings. Patients were divided into four groups based on abnormal radiographic findings or major symptoms leading to reoperation. Patients also received patient-rated wrist evaluation (PRWE) questionnaire, which were analyzed.
Results:
A total of 861 patients were included in this study. Routine follow-up radiographs were available for 844 (98%) patients. In 7.0% of patients, 6-week radiographs led to a change of standard treatment protocol, most commonly additional imaging and/or clinical follow-up. Nine (1.1%) patients underwent an urgent reoperation, and 15 (1.8%) patients underwent reoperation later in the follow-up period. All these patients were exceptionally painful/symptomatic. In addition, 33 (3.9%) patients who underwent additional imaging and follow-up after abnormal radiograph, but did not undergo reoperation, were asymptomatic or suffered only mild pain. A total of 89 (10.5%) patients had reoperation for any reason during the follow-up period.
Conclusions:
Routine follow-up radiographs after the treatment of DRF with VLP in the working-aged population rarely leads to changes in treatment strategy or reoperation in asymptomatic patients suggesting that it would be safe and cost-effective to reduce routine follow-up radiographs and focus instead on those patients with moderate-to-severe symptoms. |
| doi_str_mv | 10.1177/14574969241234740 |
| format | Article |
| fullrecord | <record><control><sourceid>sage_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1177_14574969241234740</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_14574969241234740</sage_id><sourcerecordid>10.1177_14574969241234740</sourcerecordid><originalsourceid>FETCH-LOGICAL-c335t-944cef3ea6929574de1a5e39911235ee24430a4994e2fa4ac4d66fb014c20bab3</originalsourceid><addsrcrecordid>eNp9UctqHDEQFCEhNo4_IJfQPzDOSKOdsXIzJi8wGEJyHno1rbUceTTosct-o38qPWySSyC6SHRVV6mrhXgr2ysph-G91JtBm94oLVWnB92-EOdyMKYZVD-85DfjzUo4E5c5P7Z8tFFGqdfirLvu5bUx-lw8f4u1-JnAxRDioakL-Cfc-XkHPsMcC8xkKWdMR_Az1Jn2NBdXAxCmcIRENu6JQXSFEkw-FwyQcPI1g0toS02UoSTCQhMcfHmAfQyYIET7c7VZAiOr9iGmtdDgjokLFs9G-QPcsEdJMS9ki98TZOYEaiyjbGjjQ0wFcqnT8Y145TBkuvx9X4gfnz5-v_3S3N1__np7c9fYrtuUxmhtyXWEnJ3hDCeSuKHOGMlBboiU1l2LmuMh5VCj1VPfu20rtVXtFrfdhZAnXcvfyoncuCQOLR1H2Y7rbsZ_dsM97049S90-0fS3488mmHB1ImSef3yMNc08w38UfwFre502</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Routine follow-up imaging is not necessary in uneventful early recovery after distal radius fractures treated with volar locking plate in working-aged patients: A retrospective single-center cohort study</title><source>MEDLINE</source><source>Sage Journals GOLD Open Access 2024</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Kärnä, Laura ; Launonen, Antti P. ; Luokkala, Toni ; Reito, Aleksi</creator><creatorcontrib>Kärnä, Laura ; Launonen, Antti P. ; Luokkala, Toni ; Reito, Aleksi</creatorcontrib><description>Background and objective:
The purpose of our study was to evaluate whether routine follow-up radiographs after distal radius fracture (DRF) treated with volar locking plate (VLP) influenced clinical decision-making and treatment in working-aged patients (18–65 years). We evaluated the possible correlation between clinical status and problems with follow-up radiographs and analyzed the overall reoperation rate.
Methods:
The study population of this retrospective cohort study consisted of working-aged (18–65 years) patients with DRF who were treated with VLP between January 2010 and December 2020. Baseline data, follow-up visits, and radiographs were collected. Radiographs were classified as either routinely assigned or according to clinical findings. Patients were divided into four groups based on abnormal radiographic findings or major symptoms leading to reoperation. Patients also received patient-rated wrist evaluation (PRWE) questionnaire, which were analyzed.
Results:
A total of 861 patients were included in this study. Routine follow-up radiographs were available for 844 (98%) patients. In 7.0% of patients, 6-week radiographs led to a change of standard treatment protocol, most commonly additional imaging and/or clinical follow-up. Nine (1.1%) patients underwent an urgent reoperation, and 15 (1.8%) patients underwent reoperation later in the follow-up period. All these patients were exceptionally painful/symptomatic. In addition, 33 (3.9%) patients who underwent additional imaging and follow-up after abnormal radiograph, but did not undergo reoperation, were asymptomatic or suffered only mild pain. A total of 89 (10.5%) patients had reoperation for any reason during the follow-up period.
Conclusions:
Routine follow-up radiographs after the treatment of DRF with VLP in the working-aged population rarely leads to changes in treatment strategy or reoperation in asymptomatic patients suggesting that it would be safe and cost-effective to reduce routine follow-up radiographs and focus instead on those patients with moderate-to-severe symptoms.</description><identifier>ISSN: 1457-4969</identifier><identifier>EISSN: 1799-7267</identifier><identifier>DOI: 10.1177/14574969241234740</identifier><identifier>PMID: 38618994</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal - instrumentation ; Fracture Fixation, Internal - methods ; Humans ; Male ; Middle Aged ; Radiography ; Radius Fractures - diagnostic imaging ; Radius Fractures - surgery ; Reoperation - statistics & numerical data ; Retrospective Studies ; Wrist Fractures ; Young Adult</subject><ispartof>Scandinavian journal of surgery, 2024-09, Vol.113 (3), p.189-196</ispartof><rights>The Finnish Surgical Society 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c335t-944cef3ea6929574de1a5e39911235ee24430a4994e2fa4ac4d66fb014c20bab3</cites><orcidid>0000-0003-3417-3420</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/14574969241234740$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/14574969241234740$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,21947,27832,27903,27904,44924,45312</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38618994$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kärnä, Laura</creatorcontrib><creatorcontrib>Launonen, Antti P.</creatorcontrib><creatorcontrib>Luokkala, Toni</creatorcontrib><creatorcontrib>Reito, Aleksi</creatorcontrib><title>Routine follow-up imaging is not necessary in uneventful early recovery after distal radius fractures treated with volar locking plate in working-aged patients: A retrospective single-center cohort study</title><title>Scandinavian journal of surgery</title><addtitle>Scand J Surg</addtitle><description>Background and objective:
The purpose of our study was to evaluate whether routine follow-up radiographs after distal radius fracture (DRF) treated with volar locking plate (VLP) influenced clinical decision-making and treatment in working-aged patients (18–65 years). We evaluated the possible correlation between clinical status and problems with follow-up radiographs and analyzed the overall reoperation rate.
Methods:
The study population of this retrospective cohort study consisted of working-aged (18–65 years) patients with DRF who were treated with VLP between January 2010 and December 2020. Baseline data, follow-up visits, and radiographs were collected. Radiographs were classified as either routinely assigned or according to clinical findings. Patients were divided into four groups based on abnormal radiographic findings or major symptoms leading to reoperation. Patients also received patient-rated wrist evaluation (PRWE) questionnaire, which were analyzed.
Results:
A total of 861 patients were included in this study. Routine follow-up radiographs were available for 844 (98%) patients. In 7.0% of patients, 6-week radiographs led to a change of standard treatment protocol, most commonly additional imaging and/or clinical follow-up. Nine (1.1%) patients underwent an urgent reoperation, and 15 (1.8%) patients underwent reoperation later in the follow-up period. All these patients were exceptionally painful/symptomatic. In addition, 33 (3.9%) patients who underwent additional imaging and follow-up after abnormal radiograph, but did not undergo reoperation, were asymptomatic or suffered only mild pain. A total of 89 (10.5%) patients had reoperation for any reason during the follow-up period.
Conclusions:
Routine follow-up radiographs after the treatment of DRF with VLP in the working-aged population rarely leads to changes in treatment strategy or reoperation in asymptomatic patients suggesting that it would be safe and cost-effective to reduce routine follow-up radiographs and focus instead on those patients with moderate-to-severe symptoms.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Bone Plates</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fracture Fixation, Internal - instrumentation</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Radiography</subject><subject>Radius Fractures - diagnostic imaging</subject><subject>Radius Fractures - surgery</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Wrist Fractures</subject><subject>Young Adult</subject><issn>1457-4969</issn><issn>1799-7267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>EIF</sourceid><recordid>eNp9UctqHDEQFCEhNo4_IJfQPzDOSKOdsXIzJi8wGEJyHno1rbUceTTosct-o38qPWySSyC6SHRVV6mrhXgr2ysph-G91JtBm94oLVWnB92-EOdyMKYZVD-85DfjzUo4E5c5P7Z8tFFGqdfirLvu5bUx-lw8f4u1-JnAxRDioakL-Cfc-XkHPsMcC8xkKWdMR_Az1Jn2NBdXAxCmcIRENu6JQXSFEkw-FwyQcPI1g0toS02UoSTCQhMcfHmAfQyYIET7c7VZAiOr9iGmtdDgjokLFs9G-QPcsEdJMS9ki98TZOYEaiyjbGjjQ0wFcqnT8Y145TBkuvx9X4gfnz5-v_3S3N1__np7c9fYrtuUxmhtyXWEnJ3hDCeSuKHOGMlBboiU1l2LmuMh5VCj1VPfu20rtVXtFrfdhZAnXcvfyoncuCQOLR1H2Y7rbsZ_dsM97049S90-0fS3488mmHB1ImSef3yMNc08w38UfwFre502</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Kärnä, Laura</creator><creator>Launonen, Antti P.</creator><creator>Luokkala, Toni</creator><creator>Reito, Aleksi</creator><general>SAGE Publications</general><scope>AFRWT</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0003-3417-3420</orcidid></search><sort><creationdate>20240901</creationdate><title>Routine follow-up imaging is not necessary in uneventful early recovery after distal radius fractures treated with volar locking plate in working-aged patients: A retrospective single-center cohort study</title><author>Kärnä, Laura ; Launonen, Antti P. ; Luokkala, Toni ; Reito, Aleksi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-944cef3ea6929574de1a5e39911235ee24430a4994e2fa4ac4d66fb014c20bab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Bone Plates</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fracture Fixation, Internal - instrumentation</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Radiography</topic><topic>Radius Fractures - diagnostic imaging</topic><topic>Radius Fractures - surgery</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Wrist Fractures</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kärnä, Laura</creatorcontrib><creatorcontrib>Launonen, Antti P.</creatorcontrib><creatorcontrib>Luokkala, Toni</creatorcontrib><creatorcontrib>Reito, Aleksi</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Scandinavian journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kärnä, Laura</au><au>Launonen, Antti P.</au><au>Luokkala, Toni</au><au>Reito, Aleksi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Routine follow-up imaging is not necessary in uneventful early recovery after distal radius fractures treated with volar locking plate in working-aged patients: A retrospective single-center cohort study</atitle><jtitle>Scandinavian journal of surgery</jtitle><addtitle>Scand J Surg</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>113</volume><issue>3</issue><spage>189</spage><epage>196</epage><pages>189-196</pages><issn>1457-4969</issn><eissn>1799-7267</eissn><abstract>Background and objective:
The purpose of our study was to evaluate whether routine follow-up radiographs after distal radius fracture (DRF) treated with volar locking plate (VLP) influenced clinical decision-making and treatment in working-aged patients (18–65 years). We evaluated the possible correlation between clinical status and problems with follow-up radiographs and analyzed the overall reoperation rate.
Methods:
The study population of this retrospective cohort study consisted of working-aged (18–65 years) patients with DRF who were treated with VLP between January 2010 and December 2020. Baseline data, follow-up visits, and radiographs were collected. Radiographs were classified as either routinely assigned or according to clinical findings. Patients were divided into four groups based on abnormal radiographic findings or major symptoms leading to reoperation. Patients also received patient-rated wrist evaluation (PRWE) questionnaire, which were analyzed.
Results:
A total of 861 patients were included in this study. Routine follow-up radiographs were available for 844 (98%) patients. In 7.0% of patients, 6-week radiographs led to a change of standard treatment protocol, most commonly additional imaging and/or clinical follow-up. Nine (1.1%) patients underwent an urgent reoperation, and 15 (1.8%) patients underwent reoperation later in the follow-up period. All these patients were exceptionally painful/symptomatic. In addition, 33 (3.9%) patients who underwent additional imaging and follow-up after abnormal radiograph, but did not undergo reoperation, were asymptomatic or suffered only mild pain. A total of 89 (10.5%) patients had reoperation for any reason during the follow-up period.
Conclusions:
Routine follow-up radiographs after the treatment of DRF with VLP in the working-aged population rarely leads to changes in treatment strategy or reoperation in asymptomatic patients suggesting that it would be safe and cost-effective to reduce routine follow-up radiographs and focus instead on those patients with moderate-to-severe symptoms.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>38618994</pmid><doi>10.1177/14574969241234740</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3417-3420</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Scandinavian journal of surgery, 2024-09, Vol.113 (3), p.189-196 |
| issn | 1457-4969 1799-7267 |
| language | eng |
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| source | MEDLINE; Sage Journals GOLD Open Access 2024; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adult Aged Bone Plates Female Follow-Up Studies Fracture Fixation, Internal - instrumentation Fracture Fixation, Internal - methods Humans Male Middle Aged Radiography Radius Fractures - diagnostic imaging Radius Fractures - surgery Reoperation - statistics & numerical data Retrospective Studies Wrist Fractures Young Adult |
| title | Routine follow-up imaging is not necessary in uneventful early recovery after distal radius fractures treated with volar locking plate in working-aged patients: A retrospective single-center cohort study |
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