Patient radiation doses in various fluoroscopically guided orthopaedic procedures

Area of Science:

• Orthopaedic Surgery
• Medical Imaging
• Radiation Safety

Background:

• Fluoroscopic guidance using C-arm imaging is integral to many orthopaedic procedures.
• Understanding radiation exposure parameters is crucial for patient safety and optimizing technique.

Purpose of the Study:

• To analyze and report radiation exposure metrics (fluoroscopy time, Kerma-Area Product, radiographs) for various orthopaedic procedures.
• To establish baseline data for radiation dose in C-arm guided orthopaedic interventions.

Main Methods:

• Prospective monitoring of 1-year of orthopaedic fluoroscopic procedures.
• Recording procedure type, fluoroscopy time (T), Kerma-Area Product (KAP), and number of radiographs (F).
• Categorization of procedures including intramedullary nailing (IMN) for intertrochanteric/peritrochanteric (IP) fractures and shaft fractures (TS).

Main Results:

• Intramedullary nailing (IMN) of IP fractures was most common (49.3%), followed by antergrade IMN of femur/tibia shaft (TS) fractures (13.7%).
• Significant variations in T, KAP, and F were observed across procedure types.
• Median values for IMN of IP fractures: T=2.1 min, KAP=6.3 Gy cm⁻², F=21; for antergrade IMN of TS fractures: T=2.2 min, KAP=6.3 Gy cm⁻², F=2.2.

Conclusions:

• Orthopaedic fluoroscopic procedures exhibit wide-ranging radiation exposure parameters.
• Despite variations, patient doses in these procedures are generally low relative to other interventional procedures.
• Data provides a basis for radiation dose optimization in C-arm guided orthopaedic surgery.