Ankle radiographs in the early postoperative period: do they matter?

J Orthop Trauma. 2014 Sep;28(9):538-41. doi: 10.1097/BOT.0000000000000052.


Objectives: To evaluate the utility of postoperative ankle radiographs via a comparison of complication rates among patients who had ankle radiographs in the early postoperative period versus those who obtained radiographs in a delayed fashion.

Design: Retrospective chart review.

Setting: Urban level I trauma center.

Patients/participants: Approximately 1411 patients who underwent surgical fixation of an ankle fracture between 2001 and 2010 who received postoperative ankle radiographs in postoperative days 7-120.

Intervention: Patients were identified using a current procedural terminology search and were divided between 2 groups based on the timing of the first postoperative ankle radiograph. Each chart was reviewed for complications.

Main outcome measurements: The rate of complications for patients with early postoperative ankle radiographs (7-21 days) was compared with those of patients with late postoperative radiographs (22-120 days) using χ and Fisher exact tests.

Results: Approximately 889 patients were included in the early group and 522 patients were in the late group. Overall, 93 patients with complications were identified (6.59%): 62 patients (6.97%) in the early group and 31 patients (5.93%) in the late group. The results showed no statistically significant difference in the rate of complications between the early and late groups.

Conclusions: There is insufficient evidence to suggest that complication rates following ankle fracture fixation differ by the timing of postoperative radiographs. This investigation questions the justification of routine radiographs of operatively treated ankle fractures.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

MeSH terms

  • Adult
  • Ankle Fractures / diagnostic imaging*
  • Ankle Fractures / surgery
  • Female
  • Fracture Fixation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Period
  • Radiography
  • Retrospective Studies
  • Time Factors
  • Young Adult