Is a lateral view essential in management of hip fracture?

Introduction: Neck of femur accounts to about 86,000 cases per annum in UK. AP and lateral radiographs form an essential investigation in planning the management of these fractures. Recently it has been suggested that lateral view does not provide any additional information in majority of the cases. Materials and methods: We looked retrospectively at 25 consecutive radiographs with intracapsular and extracapsular fracture neck of femur each presenting to our department between May 2010 and January 2011. These radiographs were put on the CD in 2 folders as AP and lateral. It was reviewed by 2 observers who suggested their preferred treatment. The results were compared for the intra observer agreement to assess the necessity of the lateral view of the radiographs. We also compared the treatment options with the gold standard. Results: Our results showed that lateral view did not make any difference in the management in majority of the cases with excellent agreement based on kappa statistics. Conclusion: We feel that the lateral view does not make any difference in most of the cases as shown by a good intraobserver agreement.