Exposure of medical staff to radiation during osteosynthesis of proximal femoral fracture: descriptive analysis and comparison of different devices

Arch Orthop Trauma Surg. 2017 Oct;137(10):1391-1397. doi: 10.1007/s00402-017-2761-4. Epub 2017 Jul 31.

Abstract

Background: The use of fluoroscopy is necessary during proximal femoral fracture (PFF) osteosynthesis. The frequency of these procedures justifies a description of radiation exposure and comparisons between different techniques and between the different surgical team members.

Methods: This observational prospective and comparative study includes a series of 68 patients with PFF receiving osteosynthesis. Radiation exposure was assessed for all members of the operating team. The radiation dose measurements for the different members of the surgical team during PFF osteosynthesis were compared. The factors affecting the radiation dose were investigated.

Results: The mean active dosimeter readings for each operation were 7.39 µSv for the primary surgeon, 3.93 µSv for the assistant surgeon, 1.92 µSv for the instrument nurse, 1.25 µSv for the circulating nurse, and 0.64 µSv for the anaesthesiologist, respectively. Doses decreased significantly between these different members of the medical team (all p < 0.001). The dose also varied with patient age and BMI, as well as with fluoroscopy time and operating time, but not with type of fracture or type of osteosynthesis.

Conclusion: Medical staff receives significantly different doses depending on their position in relation to the radiation source. Operating time and fluoroscopy time are the modifiable factors that affect the radiation dose. The radiation doses received by the different members of the medical teams involved in proximal femur osteosynthesis procedures all fall below the doses recommended by the International Commission on Radiation Units and Measurements.

Keywords: Femoral osteosynthesis; Radiation exposure; Surgery.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Femoral Fractures* / diagnostic imaging
  • Femoral Fractures* / surgery
  • Fluoroscopy / statistics & numerical data*
  • Fracture Fixation, Internal / statistics & numerical data*
  • Humans
  • Medical Staff / statistics & numerical data*
  • Occupational Exposure / statistics & numerical data*
  • Operative Time
  • Prospective Studies
  • Radiation Dosage
  • Radiation Exposure / statistics & numerical data*