[Radiation exposure caused by the OrthoScan mini C-arm in hand surgery: a one-year case series]

Mobile X-ray imaging systems are standard in the operating theatre. Mini-C-arms are the prevailing technology in hand surgery. Unfortunately, the exposure to Mini-C-arm radiation is often underestimated.

For one year, the intraoperative radiation dose delivered by an OrthoScan High Definition Mini-C-arm with a flat panel detector was measured using headband and finger ring dosimeters in all hand and wrist surgeries performed by three experienced hand surgeons.

Two hundred and thirteen patients underwent surgical treatment involving the use of an OrthoScan High Definition Mini-C-arm. The total radiation dose administered by all three hand surgeons over 12 months was 9033.39 mGy with a total irradiation time of 376:38 min. A radiation exposure of 2.0 mSv was detected on both finger ring dosimeters of one surgeon during one month. For all other dosimeters, the monthly radiation exposure was below the detection limit of < 0.3 mSv.

The radiation exposure reached during about 100 surgeries/surgeon/year involving the use of an OrthoScan Mini-C-arm does not exceed the annual occupational exposure limits of 50 mSv for the hand and 20 mSv for the lens of the eye. Only at an X-ray exposure of 800-1000 mGy/month can radiation exposure be detected with a finger ring dosimeter (measuring range 0.3 mSv-10 Sv) in a hand surgeon. Due to the potential health risk posed by stochastic radiation effects, all possible safeguards including behavioural measures should be observed.