Orthopaedic Department. Hospital del Mar. Barcelona. Spain

Purpose: The objective of the study is to analyze how a one-week after initial acute fracture radiological exam control influences the clinical and therapeutic decision previously adopted after initial X-ray exam evaluation.

Material and Methods: 104 acute fractures included. Mean age of 71,14 years.  79 females and 25 males. 33 acute fractures surgically treated and 71 conservatively treated. Radiological exam the day of the fracture and one week after. Classification of the fracture as displaced or on displaced, Neer classification, measurement of the shaft-humeral head angle. Comparision of initial terapeutic decision with after one-week X-ray exam therapeutic decision. Statistics: U Mann-Whitnney for comparison of 2 non normal variables.

Results: 33 acute fractures surgically treated without the need of a second X-ray exam. 71 fractures treated conservatively with no therapeutic decision change because the second X-ray exam. Shaft-humeral head angle of 141,32º in the first X-ray evaluation and of 133,76º en the second exam without significant differences. Four times a fracture was considered displaced in the first exam and non-displaced at the second exam but no change in the therapeutic decision. One fracture was considered displaced at first exam and non-displaced at second but without changing therapeutic decision.

Conclusion: In acute fractures the first X-ray exam determines the therapeutic decision. There is no need to perform a second X-ray exam at one week because this will not change the initial therapeutic decision and no significant displacement is observed.