Post-operative imaging in pediatric distal radius fractures: When tradition meets evidence

Abstract

Routine postoperative radiographs after surgical fixation of pediatric distal-radius fractures have long been part of standard care. Yet growing evidence shows that these images rarely change management in stable cases, adding unnecessary cost, radiation exposure, and clinical burden. A recent study highlights this issue and questions whether routine imaging truly benefits patient outcomes. As orthopedic care shifts toward more patient-centered and value-driven models, there is increasing support for the judicious use of radiographs, reserving imaging for cases where clinical examination or patient symptoms suggest a potential problem. This shift would reflect a broader movement within orthopedic practice: Aligning tradition with necessity, and optimizing care based on evidence rather than habit.

Keywords: Pediatric distal radius fracture; Loss of reduction; Follow-up radiographs; Cast immobilization; K-wire fixation; Re-displacement

Core Tip: Routine postoperative follow-up radiographs after closed reduction and cast immobilization or percutaneous pinning of pediatric distal radius fractures rarely influence clinical management. This editorial highlights the need for a more selective, risk-based imaging strategy that considers fracture stability, patient age, and reduction quality, aiming to reduce unnecessary radiation and costs while maintaining excellent outcomes.