TY - JOUR
T1 - Economic analysis of roentgenogram use in the closed treatment of stable ankle fractures
AU - Michelson, J. D.
AU - Ahn, U.
AU - Magid, D.
PY - 1995
Y1 - 1995
N2 - Fractures of the ankle are one of the most commonly treated injuries by orthopedic surgeons. The adequacy of closed treatment of stable lateral malleolar ankle fractures is frequently assessed by repeated roentgenograms. There are no standards, nor studies, however, that provide guidelines as to the necessity of such roentgenograms. This study was designed to determine the average frequency of follow-up roentgenograms in ankle fractures treated by casting, as well as the clinical impact of these roentgenograms. The clinical radiographic data base of a university hospital was reviewed to identify all ankle fractures treated between January 1, 1992 and June 30, 1993. A total of 82 patients satisfied the study criteria of having sustained a stable ankle fracture that was treated by closed means, with sufficient clinical and radiographic follow-up to assess healing of the fracture. All patients healed their fractures at an average of 8.4 weeks (±3.0 weeks), with weight-bearing initiated at 4.0 weeks (±2.7 weeks). No patients developed radiographic evidence of a talar shift during treatment, and none required surgery for a failure of closed treatment. At no time did any ankle exhibit a significant change in fibular alignment relative to the initial injury films. Each patient had an average of 4.5 (±2.0) radiographic studies performed throughout their treatment. This study indicates that secondary displacement of either the talus or fibula in a stable ankle fracture is very unusual. In conjunction with the generally excellent outcome for such fractures, this suggests that frequent roentgenograms are not justified on clinical grounds. Taking a wider view of this problem, it is estimated that reducing radiographic utilization in these particular injuries could save over $35 million in health expenditures in the United States each year.
AB - Fractures of the ankle are one of the most commonly treated injuries by orthopedic surgeons. The adequacy of closed treatment of stable lateral malleolar ankle fractures is frequently assessed by repeated roentgenograms. There are no standards, nor studies, however, that provide guidelines as to the necessity of such roentgenograms. This study was designed to determine the average frequency of follow-up roentgenograms in ankle fractures treated by casting, as well as the clinical impact of these roentgenograms. The clinical radiographic data base of a university hospital was reviewed to identify all ankle fractures treated between January 1, 1992 and June 30, 1993. A total of 82 patients satisfied the study criteria of having sustained a stable ankle fracture that was treated by closed means, with sufficient clinical and radiographic follow-up to assess healing of the fracture. All patients healed their fractures at an average of 8.4 weeks (±3.0 weeks), with weight-bearing initiated at 4.0 weeks (±2.7 weeks). No patients developed radiographic evidence of a talar shift during treatment, and none required surgery for a failure of closed treatment. At no time did any ankle exhibit a significant change in fibular alignment relative to the initial injury films. Each patient had an average of 4.5 (±2.0) radiographic studies performed throughout their treatment. This study indicates that secondary displacement of either the talus or fibula in a stable ankle fracture is very unusual. In conjunction with the generally excellent outcome for such fractures, this suggests that frequent roentgenograms are not justified on clinical grounds. Taking a wider view of this problem, it is estimated that reducing radiographic utilization in these particular injuries could save over $35 million in health expenditures in the United States each year.
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U2 - 10.1097/00005373-199512000-00019
DO - 10.1097/00005373-199512000-00019
M3 - Article
C2 - 7500405
AN - SCOPUS:0029608766
SN - 0022-5282
VL - 39
SP - 1119
EP - 1122
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 6
ER -