Abstract
The use of ring fixators in lower limb reconstruction and deformity correction both
for trauma and elective procedures is now widespread. The long course of treatment
requires regular outpatient review with frequent radiological imaging to assess the
progression of treatment and plan correctional adjustment.
Following publication of a technique using a frame mounted spirit-level to aid radiographers
in accurately aligning the limb for optimal imaging we implemented a similar technique
in our department and carried out a two part prospective comparative study to assess
the impact on radiograph quality.
Comparison was made of radiograph quality, X-rays taken, patient trips to the radiology
department and X-ray exposure before and after implementation of the spirit-level
guide technique in patients attending an out-patient clinic for routine follow up
following ring fixator application.
26 patients were included in the control arm and 33 in the intervention group. On
review, 42.3% of patients in the control group were deemed to have had suboptimal
imaging compared with only 9.1% of those imaged using the spirit-level guide, a statistically
significant improvement. When comparing total numbers of images taken for each group
to achieve the requested number of adequate views there was less statistical significance,
nor was there a statistically significant difference in radiation dose between the
groups.
A significant reduction in the number of inadequate images being taken, with a subsequent
reduction in patients requiring return to the radiology department for re-imaging
and then re-review in clinic, has clear implications for patients, clinicians and
hospital efficiency. The patient journey time is reduced, less time and fewer resources
are used in the radiology department and patients in clinic are seen more efficiently
and with less wasted time.
We conclude that the implementation of a simple frame mounted spirit-level as a guide
for radiographers in the outpatient clinic significantly reduces the number of suboptimal
and wasted images taken in the assessment of patients being treated by ring fixator.
Keywords
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Article info
Publication history
Accepted:
January 24,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
