Radiation exposure with use of the mini-C-arm for routine orthopaedic imaging procedures

The use of mobile fluoroscopic devices during orthopaedic procedures is associated with substantial concern with regard to the radiation exposure to surgeons and support staff. The perceived increased risks associated with large c-arm devices have been well documented. However, no study to date has documented the relative radiation risk associated with the use of a mini-c-arm device. The purpose of the current study was to determine the amount of radiation received by the surgeon during the use of a mini-c-arm device and to compare this amount with documented measurements associated with the large c-arm device.

With use of a radiation dosimeter, measurements were carried out with tissue-equivalent anthropomorphic phantoms to quantitatively determine exposure rates at various locations and distances from the mini-c-arm for two common upper and lower extremity procedures.

Regardless of position, distance, or relative duration of exposure, exposure rates resulting from the use of the mini-c-arm device were one to two orders of magnitude lower than those reported in the literature in association with the use of the large c-arm device.

The mini-c-arm device should be utilized whenever feasible in order to eliminate many of the concerns associated with use of the large c-arm device, specifically those related to cumulative radiation hazards, positioning considerations, relative distance from the beam, and the need for protective shielding.