Accuracy of a modified axiolateral radiographic hip projection in suspected cases of hip fracture: experience and results from a regional trauma centre.

Conventional radiographs play an important role as a first line imaging modality in the assessment for suspected hip fractures in the majority of trauma centres. The routinely performed radiographic projections in our emergency department for patients with clinically suspected hip fractures include antero-posterior (AP) and cross-table lateral views of the affected hip. Certain clinical scenarios which include the presence of significant pain of the injured lower limb, a large patient habitus, as well as pre-existing patient morbidity which would limit the range of motion of the lower limbs, for example the presence of prior joint replacement surgery or lower limb contractures, may however preclude proper positioning of the patient to obtain an optimal cross-table lateral view of the affected hip. The objective of this study is to investigate whether a modified axiolateral hip projection would be a feasible alternative to the cross-table lateral projection in the initial radiographic assessment of suspected cases of hip fracture.