Role of post-operative X-rays in distal-radius fractures among pediatric patients

Table 1 Descriptive statistics of study data

Variable	Group	Frequency (%)
Gender	Male	77 (87.5)
	Female	11 (12.5)
Age (arbitrary classifications)	3-5 years old	17 (19.3)
	6-8 years old	16 (18.2)
	9-11 years old	18 (20.5)
	12-14 years old	36 (40.9)
Site of fracture	Epiphyseal	15 (17.0)
	Metaphyseal	27 (30.7)
	Diaphyseal	46 (52.3)
Type of fixation/surgery	Closed reduction	65 (73.9)
	Open reduction	12 (13.6)
	Internal fixation	11 (12.5)
	CRIF	1 (1.1)
	ORIF	1 (1.1)
	Debridement	1 (1.1)
	Epiphysiodesis	1 (1.1)
	One K wire fixation	58 (65.9)
	Two K wire fixation	13 (14.8)
	TENS	11 (12.5)
Complications	Yes	2 (2.3)
	No	86 (97.7)
Change in management plan	Yes	8 (9.1)
	No	80 (90.9)
Second operation	Yes	4 (4.5)
	No	84 (95.5)

CRIF: Close reduction and internal fixation; TENS: Titanium elastic nailing system; ORIF: Open reduction and internal fixation.

Table 2 Postoperative X-ray follow-up intervals and frequencies

X-ray post op	Frequency (%)
1-2 weeks	54 (61.4)
3-4 weeks	40 (45.5)
5-6 weeks	14 (15.9)
7-8 weeks	19 (21.6)
9-10 weeks	4 (4.5)
11-12 weeks	4 (4.5)
13-14 weeks	4 (4.5)
4 months	3 (3.4)
5 months	6 (6.8)
6 months	2 (2.3)
7 months	1 (1.1)
8 months	2 (2.3)
9 months	1 (1.1)
10 months	2 (2.3)
11 months	1 (1.1)
1 year	5 (5.7)
1 year and a half	1 (1.1)
2 years	2 (2.3)
3-4 years	1 (1.1)

Table 3 Frequency of second operation follow-up X-ray

Second operation X-ray	Frequency (%)
1-2 weeks	2 (50)
3-4 weeks	2 (50)
6 weeks	2 (50)
9 weeks	2 (50)
3 months	1 (25)
9 months	1 (25)

Table 4 Bivariate analysis to assess the influence of the number of X-rays on the study variables

Variable	Frequency (%)	Total X-rays (median) (IQR)	Test (P value)
Gender	-	-	Mann-Whitney U = 348.500 (0.328)
Male	77 (87.5)	2.00 (1)
Female	11 (12.5)	1.00 (3)
Age			Kruskal-Wallis H = 0.378 (0.223)
3-5 years old	17 (19.3)	2.00 (2)
6-8 years old	16 (18.2)	2.00 (1)
9-11 years old	18 (20.5)	2.00 (2)
12-14 years old	36 (40.9)	2.00 (2)
Site of fracture			Kruskal-Wallis H = 0.201 (0.905)
Epiphyseal	15 (17.0)	2.00 (1)
Metaphyseal	27 (30.7)	2.00 (1)
Diaphyseal	46 (52.3)	2.00 (2)
Complications			Mann-Whitney U = 75.00 (0.774)
Yes	2 (2.3)	1.50 (0)
No	86 (97.7)	2.00 (1)
Change in management plan			Mann-Whitney U = 307.00 (0.845)
Yes	8 (9.1)	2.00 (3)
No	80 (90.9)	2.00 (1)
Second operation			Mann-Whitney U = 148.500 (0.706)
Yes	4 (4.5)	1.50 (3)
No	84 (95.5)	2.00 (1)

IQR: Interquartile range.

Table 5 Bivariate analysis to assess the association between the number of X-rays and the type of fixation

Type of fixation	Frequency (%)	Total X-rays Median (IQR)	Mann-Whitney U test (P value)
Closed reduction	65 (73.9)	2.00 (1)	584.00 (0.108)
Open reduction	12 (13.6)	2.00 (1)	317.50 (0.082)
Internal fixation	11 (12.5)	2.00 (1)	312.00 (0.146)
ORIF	4 (4.5)	1.00 (2)	110.00 (0.261)
One K wire fixation	58 (65.9)	2.00 (1)	778.00 (0.403)
Two K wire fixation	13 (14.8)	2.00 (2)	431.00 (0.492)
TENS	11 (12.5)	2.00 (4)	387.00 (0.634)
Other1	3 (3.4)	3.00 (0)	95.00 (0.481)

¹Close reduction and internal fixation, debridement, epiphysiodesis.

TENS: Titanium elastic nailing system; ORIF: Open reduction and internal fixation; IQR: Interquartile range.

Table 6 Odds ratio to compare the variables that significantly influence the number of X-rays (≤ 1 X-ray or ≥ 2 X-rays)

Variables	OR1	95%CI
Gender
Female	1	-
Male	2.897 (0.112)	0.780-10.758
Age
3-5 years old	1	-
6-8 years old	1.143 (0.849)	0.290-4.507
9-11 years old	3.111 (0.129)	0.720-13.443
12-14 years old	0.993 (0.991)	0.313-3.155
Site of fracture
Epiphyseal	1	-
Metaphyseal	1.273 (0.710)	0.357-4.542
Diaphyseal	1.361 (.607)	0.421, 4.405
Complications
No	1	-
Yes	0.686 (0.793)	0.042-11.342
Change in management plan
No	1	-
Yes	1.170 (0.837)	0.261-5.239
Second operation
No	1	-
Yes	0.680 (0.707)	0.091-5.064

¹The constant in the outcome variable is ≤ 1 X-ray done after post op compared to ≥ 2 X-rays.

OR: Odds ratio; CI: Confidence interval.

Table 7 Odds ratio to compare the type of fixation that significantly influence the number of X-rays (≤ 1 X-ray or ≥ 2 X-rays)

Type of fixation	OR1	95%CI
Closed reduction	0.305 (0.035)	0.101-0.919
Open reduction	4.048 (0.084)	0.830-19.731
Internal fixation	3.558 (0.119)	0.721-17.568
ORIF	0.680 (0.707)	0.091-5.064
K wire fixation	0.615 (0.300)	0.246-1.542
2 K wire fixation	1.674 (0.424)	0.473-5.924
TENS	1.244 (0.743)	0.336-4.609
Other2	3.723 (0.240)	0.416-33.308

¹The constant in the outcome variable is ≤ 1 X-ray done after post op compared to ≥ 2 X-rays.

²Other: Close reduction and internal fixation, debridement, or close k- wiring.

OR: Odds ratio; CI: Confidence interval; TENS: Titanium elastic nailing system; ORIF: Open reduction and internal fixation.