Journal of Orthopaedics Trauma Surgery and Related Research

Journal of Orthopaedics Trauma Surgery and Related Research

An Official Journal of Polish Society of Orthopaedics and Traumatology

e-ISSN: 2449-9145

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

High number of negative radiographs for suspected tibial shaft fracture adds expense and increases patient throughput time in the emergency department

Joint Event on 13th International Conference on ARTHRITIS AND RHEUMATOLOGY & 3rd International Conference on ANATOMY AND PHYSIOLOGY

December 9-10, 2019 | Barcelona, Spain

Safa Fassihi

George Washington University Hospital, USA

Posters & Accepted Abstracts: J Orthop Trauma Surg Rel Res

Abstract :

Purpose: The diagnosis of tibial shaft fractures (OTA 42A-C) is commonly made by emergency department (ED) providers prior to orthopedic consultation. Due to the subcutaneous anatomy of the tibia, a comprehensive history and physical examination are often sufficient for fracture diagnosis, with radiographs serving as a secondary aid. A high rate of negative X-Rays increases cost and inefficiency in the ED. This study aims to define the rate at which tibial radiographs are negative for suspected fracture.

Methods: At a Level I trauma center, a prospective database was retrospectively evaluated for ED radiographs taken from 2014 to 2016. Only radiographs obtained for suspected fracture of the tibial diaphysis were included. From this, the rate of negative diagnostic studies and the associated costs, ED throughput time, resource utilization, and radiation exposure were calculated.

Results: During the study period, 734 tibia radiographs were performed for diagnosis of tibial shaft fracture without suspected adjacent articular pathology. Of these, 565 (76.9%) were negative for tibial shaft fracture. Patient charges were increased by these radiographs through both higher radiology charges ($598 per tibia radiographic series) and higher professional charges. The mean time to obtain a tibia X-ray series in the ED was 57 minutes (SD: 47 minutes; Median: 47 minutes). The radiation exposure from a tibia radiographic series was 15 millirems.

Conclusion: At this institution, a large proportion of the radiographs obtained for suspected tibial shaft fracture are negative. The resources and time spent acquiring these radiographs places higher demands on physicians and staff while increasing charges and radiation exposure to patients. In addition, these negative radiographs add throughput time in the ED, thereby potentially contributing to ED overcrowding. The authors propose a systematic approach to maximize the diagnostic efficiency of tibia radiographs and subsequently improve resource allocation in the ED.

Biography :

Safa Fassihi is a US-based physician pursuing a career in orthopedic total joint arthroplasty. His research focuses not only on total joint arthroplasty but also on improving the procedural and financial efficiency of the healthcare system. This specific analysis was based upon his experience at a level 1 trauma center, in which he recognized that there was significant emergency department overcrowding on a regular basis, so he sought to minimize any factors that may be contributing to this problem. He noticed that tibia X-rays were frequently ordered for suspected tibial shaft fracture and were negative most of the time. He collaborated with a US board-certified orthopedic traumatologist to identify the extent of this problem and offer a potential solution.


Select your language of interest to view the total content in your interested language

20+ Million Readerbase
Indexed in

Embase/EXPERTA MEDICA Road Directory of Open Access
Scholarly Resources
Publons MIAR GBL Ministry of Science and Higher
Index Copernicus
Google Scholar citation report
Citations : 281

Journal of Orthopaedics Trauma Surgery and Related Research received 281 citations as per Google Scholar report

Journal of Orthopaedics Trauma Surgery and Related Research peer review process verified at publons
SCImago Journal & Country Rank
Annals of Medical and Health Sciences Research Journal of Orthopaedics Trauma Surgery and Related Research a publication of Polish Society, is a peer-reviewed online journal with quaterly print on demand compilation of issues published.
Submit your Manuscript

Recommended Conferences

17th Global Summit on Orthopedics and Physiotherapy
Paris, France