Fluoroscopic radiation exposure: are we protecting ourselves adequately?

Area of Science:

• Medical Physics
• Orthopedic Surgery
• Radiation Safety

Background:

• Traditional intraoperative fluoroscopy protection (thyroid shields, aprons) may be insufficient.
• Surgeons' eyes and hands receive significant radiation exposure, often underestimated.
• Distal radial fracture surgery using fluoroscopy presents a specific exposure scenario.

Purpose of the Study:

• To quantify radiation exposure to various body parts (eyes, thyroid, chest, groin, hands) of a surgeon mannequin.
• To evaluate the effectiveness of protective equipment in reducing radiation exposure.
• To compare radiation exposure between mini and standard fluoroscopy units.

Main Methods:

• An anthropomorphic model was equipped with radiation-attenuating glasses, thyroid shield, apron, and gloves.
• Thermoluminescent dosimeters measured radiation exposure at eyes, thyroid, chest, groin, and index finger (both exposed and shielded).
• Three mini and three standard c-arms were used to simulate wrist fluoroscopy for 15 minutes each.

Main Results:

• Hand exposure was highest (31 μSv/min), 13 times greater than other measured areas.
• Eye exposure (4 μSv/min) was 2.2 times higher than thyroid, chest, and groin exposure.
• Gloves reduced hand exposure by 69.4%; glasses reduced eye exposure by 65.6%; no significant difference between mini/standard fluoroscopy units.

Conclusions:

• Surgeons' hands and eyes are primary sites of radiation exposure during distal radial plate fixation.
• Routine use of protective equipment (gloves, glasses) is recommended to mitigate hand and eye exposure.
• No significant difference in exposure was found between mini and standard fluoroscopy units.