Defining reference levels for intra-operative radiation exposure in orthopaedic trauma: A retrospective multicentre...

Area of Science:

• Medical Physics
• Orthopaedic Surgery
• Radiology

Background:

• Limited data exists for ionising radiation reference levels in orthopaedic trauma surgery.
• Current practices lack standardized benchmarks for fluoroscopy use.

Purpose of the Study:

• To establish reference levels for common orthopaedic trauma procedures using established methodology.
• To guide and audit fluoroscopy practices in orthopaedic trauma surgery.

Main Methods:

• A multicentre study analyzed 495 procedures across four London hospitals over one year.
• Exposure was measured using dose area product (DAP) and time.
• Reference levels were defined using third quartile mean values for DAP and time.

Main Results:

• Reference levels were determined for procedures including dynamic hip screw (DHS) and intramedullary (IM) femoral nail fixation.
• Surgeon grade showed no influence on DHS exposure but was inversely related to IM nail exposure.
• Exposure time exhibited less variation between centers and surgeons compared to DAP.

Conclusions:

• This study provides comprehensive reference levels for fluoroscopy in orthopaedic trauma.
• The established levels are valuable for real-time guidance and practice audits.
• Standardizing radiation exposure is key for patient safety in orthopaedic trauma procedures.