New Study Questions Necessity of Routine X-Rays After Canine Forelimb Fracture Surgery

Influence of Routine Follow‐Up Radiographs on Recommendations for Management of Antebrachial Fractures in Dogs

K. Goggin, D. McDonald, A. Gal, N. Nakahara, S. Lane, W. Park

Background
Antebrachial fractures (radius and ulna) are common in dogs, particularly small breeds, and often require internal fixation. Routine postoperative radiographs are traditionally used to monitor healing and guide recovery. However, in both human and veterinary orthopaedics, the value of routine imaging in asymptomatic patients has been increasingly scrutinized. This study aimed to determine how often routine follow-up radiographs influence postoperative management in dogs without clinical or owner-reported concerns.

Methods
This retrospective multi-institutional case series analyzed 208 client-owned dogs treated with internal fixation for antebrachial fractures. Inclusion required scheduled radiographic follow-up 4–10 weeks post-surgery. Data included clinical exams, owner concerns, radiographic findings, and changes to postoperative plans. Radiographic findings were categorized as isolated (no clinical or owner concern) or combined with such concerns. Statistical analysis employed logistic regression with Firth’s correction to identify predictors of management changes.

Results
Postoperative management was altered in 26.9% (56/208) of dogs, mostly due to clinical or owner concern. Radiographic findings prompted changes in 18.3% (38/208) of cases, but only 3.85% (8/208) had isolated radiographic abnormalities that led to plan changes. Most of these changes were minor and included repeat imaging or elective implant removal. Revision surgery and major interventions were overwhelmingly associated with concurrent clinical or owner concerns. Unexpected veterinary revisits significantly increased the likelihood of plan changes, while toy breed status, fracture type, and open vs. closed classification did not.

Limitations
As a retrospective study, the findings rely on medical record completeness and surgeon documentation. Radiographs were interpreted by operating surgeons rather than radiologists, possibly introducing observer bias. The study did not employ objective functional outcome measures such as force plate analysis, and the sequence of clinical versus radiographic evaluations could not always be confirmed. Differences among institutions may have influenced variability in practice and outcomes.

Conclusions
Routine postoperative radiographs in dogs recovering from antebrachial fracture repair rarely influenced management in the absence of clinical or owner-reported concerns. The low prevalence and limited clinical significance of isolated radiographic abnormalities support a more selective, examination-guided approach to follow-up imaging. This strategy may reduce costs, anesthesia exposure, and unnecessary interventions while maintaining high-quality patient care.

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