Are Unnecessary Serial Radiographs Being Ordered in Children with Distal Radius Buckle Fractures?

Abstract

<i>Background.</i> Torus or buckle distal radius fractures are common injuries in the pediatric population. By definition, they are stable and can be treated conservatively with a wrist splint or soft crepe bandage. <i>Objective.</i> The objective of this study was to evaluate the utility of serial radiographs in the clinical outcome of children with stable distal radius buckle fractures. <i>Materials and Methods.</i> A one-month retrospective analysis was undertaken at two major hospitals in Queensland-Logan and Redlands Hospital. Statistical analysis was performed to identify any relationships between serial radiographs and certain demographic parameters including fracture characteristics, age, sex, and limb side. <i>Results.</i> Of the 136 patients, 50% had more than one radiograph series taken. A total of 576 single radiographs and 251 radiograph series were taken. All fractures healed without complications and did not require active intervention. There was a statistically significant relationship (<i>p</i> = 0.0015) between fracture angulation and multiple radiographs series. A cost analysis revealed $55,890 per year could be saved by not performing serial radiographs. <i>Conclusion.</i> Serial radiographs did not appear to change the excellent clinical outcome for children with distal radius buckle fractures. There is a potential to reduce costs and prevent unnecessary ionizing radiation exposure to children.