• William M Ricci, James C Black, Paul Tornetta, Michael J Gardner, Christopher M McAndrew, and Roy W Sanders.
• *Washington University Orthopaedics, Washington University School of Medicine, St. Louis, MO; †Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA; and ‡Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa General Hospital, Tampa, FL.
• J Orthop Trauma. 2016 Mar 1; 30 (3): e100-5.

ObjectivesTo determine current practice standards among Orthopaedic Trauma Association surgeons for postoperative fracture follow-up and to investigate the implications of these standards on clinical research.DesignSurvey.SettingWeb-based survey.ParticipantsOne hundred eighty-four orthopaedic trauma surgeons.MethodsA web-based questionnaire was distributed to Orthopaedic Trauma Association members to identify standard postoperative radiographic and clinical follow-up duration. Assuming uneventful, complete fracture healing at 3 months, data were collected for 3 generic fracture types (diaphyseal, extra-articular metaphyseal, and intra-articular) and 3 specific fractures (femoral shaft, intertrochanteric, and tibial plateau). Suggested follow-up for clinical research was also investigated.ResultsFor extra-articular fractures, standard radiographic and clinical follow-up were considered to be 6 months or less by greater than 70% of respondents. For intra-articular fractures, standard radiographic and clinical follow-up was considered to be 6 months or less by greater than 39% of respondents. The most common responses for radiographic follow-up were 3 months for extra-articular fractures (33%) and 12 months for intra-articular fractures (34%). The most common responses for clinical follow-up were 6 months for extra-articular fractures (37%) and 12 months for intra-articular fractures (35%). The majority (55%) indicated that follow-up to clinical and radiographic healing or the establishment of a nonunion should be the minimum follow-up for clinical fracture studies and 66% recommended follow-up to at least 1 year for functional outcome studies.ConclusionsMost surgeons follow-up patients with lower extremity extra-articular fractures (with uneventful healing) radiographically for 3-6 months and clinically for 6 months and slightly longer for intra-articular fractures. Many surgeons cease radiographic and clinical follow-up by 6 months. Therefore, retrospective fracture healing studies can only reasonably expect follow-up for 6 months. Publication requirements for longer follow-up of fracture-related studies would likely eliminated retrospective studies from consideration. Most surgeons support obtaining at least 1-year follow-up for clinical studies that include functional outcome.Level Of EvidenceTherapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.

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