Intraoperative Fluoroscopic Radiation Exposure During Hip Fracture Fixation: A Study Combining Surgical Experience...

Area of Science:

• Orthopaedic Surgery
• Trauma Surgery
• Medical Physics

Background:

• Hip fracture fixation is a common surgical procedure requiring significant expertise.
• Intraoperative fluoroscopy use in hip fracture surgery poses radiation hazards to surgical teams.
• Balancing surgical training needs with radiation safety is crucial.

Purpose of the Study:

• To investigate the relationship between surgeon's training grade, hip fracture complexity, and intraoperative radiation exposure.
• To identify factors influencing fluoroscopic radiation dose during hip fracture fixation.
• To inform strategies for optimizing radiation safety in orthopaedic training.

Main Methods:

• Retrospective analysis of peri-operative data from 268 hip fracture patients over two years.
• Data collected included surgeon's training grade (Junior Trainee, Senior Trainee, Consultant), fracture complexity (AO/OTA Classification), and intraoperative radiation dose (centi-Gray/cm²).
• Exclusion criteria: femoral head, subtrochanteric, diaphyseal, and trochanteric fractures with pelvic fractures.

Main Results:

• Higher fluoroscopic radiation exposure was significantly associated with junior trainee surgeons (p = 0.005) and more complex fracture patterns (p < 0.001).
• No significant differences in patient demographics (age, gender, BMI) or basic fracture patterns were found across surgeon training groups.
• Consultants operated on patients with higher American Society of Anesthesiologists (ASA) grades, indicating more comorbidities.

Conclusions:

• Intraoperative radiation dose during hip fracture fixation is significantly influenced by the surgeon's training level and fracture complexity.
• The findings underscore the importance of comprehensive, supervised orthopaedic training for in-theatre radiation safety.
• A balance between surgical education, learning, and radiation hazard prevention is essential for successful patient outcomes and trainee development.