Current Opinions on Fracture Follow-up: A Survey of OTA Members Regarding Standards of Care and Implications for Clinical Research

William M. Ricci, James C. Black, Paul Tornetta, Michael J. Gardner, Christopher M. McAndrew, Roy W. Sanders

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objectives: To determine current practice standards among Orthopaedic Trauma Association surgeons for postoperative fracture follow-up and to investigate the implications of these standards on clinical research. Design: Survey. Setting: Web-based survey. Participants: One hundred eighty-four orthopaedic trauma surgeons. Methods: A web-based questionnaire was distributed to Orthopaedic Trauma Association members to identify standard postoperative radiographic and clinical follow-up duration. Assuming uneventful, complete fracture healing at 3 months, data were collected for 3 generic fracture types (diaphyseal, extra-articular metaphyseal, and intra-articular) and 3 specific fractures (femoral shaft, intertrochanteric, and tibial plateau). Suggested follow-up for clinical research was also investigated. Results: For extra-articular fractures, standard radiographic and clinical follow-up were considered to be 6 months or less by greater than 70% of respondents. For intra-articular fractures, standard radiographic and clinical follow-up was considered to be 6 months or less by greater than 39% of respondents. The most common responses for radiographic follow-up were 3 months for extra-articular fractures (33%) and 12 months for intra-articular fractures (34%). The most common responses for clinical follow-up were 6 months for extra-articular fractures (37%) and 12 months for intra-articular fractures (35%). The majority (55%) indicated that follow-up to clinical and radiographic healing or the establishment of a nonunion should be the minimum follow-up for clinical fracture studies and 66% recommended follow-up to at least 1 year for functional outcome studies. Conclusions: Most surgeons follow-up patients with lower extremity extra-articular fractures (with uneventful healing) radiographically for 3-6 months and clinically for 6 months and slightly longer for intra-articular fractures. Many surgeons cease radiographic and clinical follow-up by 6 months. Therefore, retrospective fracture healing studies can only reasonably expect follow-up for 6 months. Publication requirements for longer follow-up of fracture-related studies would likely eliminated retrospective studies from consideration. Most surgeons support obtaining at least 1-year follow-up for clinical studies that include functional outcome.

Original languageEnglish
Pages (from-to)e100-e105
JournalJournal of orthopaedic trauma
Volume30
Issue number3
DOIs
StatePublished - Mar 1 2016

Keywords

  • fracture follow-up
  • fracture healing
  • radiographic timing
  • research
  • survey

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