Download PDF
Osteosynthesis and Trauma Care 2003; 11(2): 84-87
DOI: 10.1055/s-2003-42521
Original Article

© Georg Thieme Verlag Stuttgart · New York

Time of Fluoroscopy Use in Orthopedic Trauma Cases

C. H. Crawford1 , D. Seligson1 , A. L. Malkani1 , C. S. Roberts1
  • 1Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
Further Information

Publication History

Publication Date:
06 October 2003 (online)

    Permissions and Reprints

Abstract

The purpose of this study was to identify the orthopedic trauma cases requiring the most fluoroscopic time. We retrospectively reviewed three hundred and fifty-six consecutive orthopedic trauma patients who presented to a level one trauma center. Time of fluoroscopy, case type, and surgeon were recorded for each surgical case. The four case types requiring the most fluoroscopic time were: intramedullary nailing of the femur (mean=2.23 minutes); intramedullary nailing of the tibia (mean=1.53 minutes); plating of the calcaneus (mean=1.5 minutes); and sacroiliac screw placement (mean=1.67 minutes). There was no significant difference between surgeons. Intramedullary nailing, calcaneal plating, and sacroiliac screw placement are the orthopedic trauma cases that require the most fluoroscopic time. These procedures may be targeted when attempting to decrease radiation exposure to patients and operating room staff.

Key words

Fluoroscopy - radiation exposure - time - orthopedic trauma

References

  • 1 Barry T P. Radiation exposure to an orthopaedic surgeon.  Clin Orthop. 1984;  182 160-164
    PubMedGoogle Scholar
  • 2 Coetzee J C, van der Merwe E J. Exposure of surgeons-in-training to radiation during intramedullary fixation of femoral shaft fractures.  S Afr Med J. 1992;  81 312-314
    PubMedGoogle Scholar
  • 3 Cope M R, Shaw D L. The use and availability of thyroid shields in orthopedic theatres: a telephone questionnaire of English hospitals.  Ann R Coll Surg Engl. 2002;  84 193-195
    PubMedGoogle Scholar
  • 4 Dosch J C, Dupius M, Beck G. Strahlungsmessungen bei Verriegelungsnagelungen.  Hefte Unfallheilk. 1983;  161 36-38
    PubMedGoogle Scholar
  • 5 Faulkner K, Moores B M. An assessment of the radiation dose received by staff using fluoroscopic equipment.  Br J Radiol. 1982;  55 272-276
    PubMedGoogle Scholar
  • 6 Fuchs M, Modler H, Schmid A, Dumont C, St ümer K M. Monitoring of trauma surgeons' exposure to radiation. Measurements of head, eye and thyroid with highly sensitive thermoluminescene detectors.  Der Unfallchirurg. 1999;  102 371-376
    CrossrefPubMedGoogle Scholar
  • 7 Giachino A A, Cheng M. Irradiation of the surgeon during pinning of femoral fractures.  J Bone Joint Surg [Br]. 1980;  62 227-229
    PubMedGoogle Scholar
  • 8 Goldstone K E, Wright I H, Cohen B. Radiation exposure to the hands of orthopaedic surgeons during procedures under fluoroscopic X-ray control.  Br J Radiol. 1993;  66 899-901
    PubMedGoogle Scholar
  • 9 Herscovici D J r, Sanders R W. The effects, risks, and guidelines for radiation use in orthopaedic surgery.  Clin Orthop. 2000;  375 126-132
    PubMedGoogle Scholar
  • 10 Jones D G, Stoddart J. Radiation use in the orthopaedic theatre: a prospective audit.  Aust N Z J Surg. 1998;  68 782-784
    PubMedGoogle Scholar
  • 11 Larson B J, Egbert J, Goble E M. Radiation exposure during fluoroarthroscopically assisted anterior cruciate reconstruction.  Am J Sports Med. 1995;  23 462-464
    PubMedGoogle Scholar
  • 12 Levin P E, Schoen R W, Browner B D. Radiation exposure to the surgeon during closed interlocking intramedullary nailing.  J Bone Joint Surg [Am]. 1987;  69 761-766
    PubMedGoogle Scholar
  • 13 Lewall D B, Riley P, Hassoon A A, McParkland B J. A fluoroscopy credentialing programme for orthopedic surgeons.  J Bone Joint Surgery [Br]. 1995;  77 442-444
    PubMedGoogle Scholar
  • 14 Little J B. Biologic effects of low-level radiation exposure. In Radiology: Diagnosis, Imaging, Intervention, ed by JM Taveras. JB Lippincott, Philadelphia 1992; 1-12
    Google Scholar
  • 15 Mehlman C T, DiPasquale T G. Radiation exposure to the orthopedic surgical team during fluoroscopy: ”how far away is far enough?”.  J Orthop Trauma. 1997;  11 392-398
    CrossrefPubMedGoogle Scholar
  • 16 Miller M E, Davis M L, MacClean C R, Davis J G, Smith B L, Humphries J R. Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guidance for selected orthopaedic surgical procedures.  J Bone Joint Surg [Am]. 1983;  65 1-4
    PubMedGoogle Scholar
  • 17 Muller L P, Suffner J, Mohr W, Degreif J, Rommens P M. Effectiveness of lead thyroid shield for reducing roentgen ray exposure in trauma surgery interventions of the lower leg.  Unfallchirurgie. 1997;  23 246-251
    PubMedGoogle Scholar
  • 18 National Council on Radiation Protection and Measurements Review of Current State of Radiation Protection Philosophy .Limitation of Exposure of Ionizing Radiation Report #116. Bethesda, MD, United States Government Printing Office 1993
    Google Scholar
  • 19 O’Rourke P J, Crerand S, Harrington P, Casey M, Quinlan W. Risks of radiation exposure to orthopaedic surgeons.  J R Coll Surg Edinb. 1996;  41 40-43
    PubMedGoogle Scholar
  • 20 Riley S A. Radiation exposure from fluoroscopy during orthopedic surgical procedures.  Clin Orthop. 1989;  248 257-260
    PubMedGoogle Scholar
  • 21 Sanders R, Koval K J, DiPasquale T, Schmelling G, Stenzler S, Ross E. Exposure of the orthopaedic surgeon to radiation.  J Bone Joint Surgery [Am]. 1993;  75 326-330
    PubMedGoogle Scholar
  • 22 Sinclair W K. Radiation protection recommendations on dose limits: the role of the NCRP and the ICRP and future developments.  Physics. 1995;  31 387-392
    PubMedGoogle Scholar
  • 23 Suhm N, Jacob A L, Zuna I, Roser H W, Regazzoni P, Messmer P. Radiation exposure of the patient by intraoperative imaging of intramedullary osteosyntheses.  Radiologe. 2001;  41 91-94
    CrossrefPubMedGoogle Scholar
  • 24 Tse V, Lising J, Khadra M, Chiam Q, Nugent R, Yeaman L, Mulchany M. Radiation exposure during fluoroscopy: should we be protecting our thyroids?.  Aust N Z J Surg. 1999;  69 847-848
    PubMedGoogle Scholar

Dr. David Seligson

Department of Orthopedic Surgery · University of Louisville School of Medicine

530 South Jackson Street, Louisville, KY 40202 · USA

Phone: +1/5 02-8 52-09 23

Fax: +1/5 02-8 52-72 27

      >