Intraoperative Radiation Exposure During Midfoot Charcot Reconstruction

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Radiation Safety

Background:

• Radiation exposure is a concern in foot and ankle surgery, particularly during hindfoot deformity correction.
• Data on radiation exposure during Charcot reconstruction is limited.
• Intraoperative fluoroscopy is essential for complex Charcot reconstructions.

Purpose of the Study:

• To compare radiation exposure during midfoot Charcot reconstruction across different pathologies and fixation constructs.
• To identify factors influencing radiation exposure and fluoroscopy time in Charcot reconstruction.

Main Methods:

• Retrospective chart review of 40 patients undergoing midfoot Charcot reconstruction (2016-2022).
• Analysis of demographics, pathology, and intervention variables.
• Comparison of radiation exposure (mGy) and fluoroscopy times (seconds) among different midfoot constructs.

Main Results:

• Average radiation exposure was 9.5 ± 5.39 mGy and average fluoroscopy time was 256.64 ± 130.67 seconds.
• No significant difference in radiation exposure or fluoroscopy time was found among different midfoot fixation constructs (p > .05).
• Radiation exposure and fluoroscopy time were significantly correlated with patient weight, body mass index, and procedure complexity (number of stages/beams/screws).

Conclusions:

• Surgeons must be aware of fluoroscopy usage during complex Charcot reconstructions.
• Patient weight, BMI, and procedural complexity are key factors influencing radiation exposure.
• Personal protective equipment is recommended for providers performing frequent Charcot reconstructions.