Traumatic skeletal fractures are commonly encountered in health care and present a large medical and socio-economic burden [1, 2]. The majority of fractures occur in either the upper or lower extremity. For example, fractures of the wrist, hand, and ankle represent roughly 50% of all skeletal fractures . Due to the aging population, the incidence of extremity fractures is expected to increase in the coming decades . Current national and international protocols recommend frequent outpatient clinic visits at which radiographs of the fractured extremity are obtained. These radiographs can be used to check for (secondary) dislocation, assess bone healing, and provide early detection of complications [5, 6, 7, 8]. Other reasons for radiographic imaging include resident education, reassurance of patients, and medicolegal protection . The costs and cost-effectiveness of diagnostic imaging for traumatic skeletal fractures are becoming increasingly important factors in clinical decision making . Recent studies have assessed routine radiography use in patients with distal radius and ankle fractures. These studies suggested that radiographs obtained without a clinical indication do not lead to changes in treatment strategy whilst adding to treatment cost [11, 12, 13]. The added value of radiographs for other fractures of the extremities and their consequences for treatment strategies are still unclear. Therefore, the aim of this review was to analyze studies that examine the influence of follow-up radiography for extremity fractures on treatment strategy. Specifically, we focused on whether omission of these more or less routine radiographs is associated with a delayed detection of complications and subsequently a possible deteriorated functional outcome.
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