Fluoroscopy in Hip Fracture Surgery: An Analysis of Resident Utilization

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Radiation Safety

Background:

• Fluoroscopy is essential for fracture reduction and fixation, with residents using it early in training.
• Current training lacks detailed analysis of fluoroscopy distribution during procedures.
• Understanding fluoroscopy use patterns is crucial for optimizing radiation dose management.

Purpose of the Study:

• To quantify resident fluoroscopy use during cephalomedullary nail (CMN) fixation.
• To identify specific procedural tasks that consume the most fluoroscopy time and images.
• To inform training strategies for radiation dose reduction.

Main Methods:

• Analysis of 85 CMN cases with complete fluoroscopic images.
• Detailed breakdown of fluoroscopy use across nine distinct surgical tasks.
• Data collection attributed to the most junior resident performing the procedure.

Main Results:

• Residents averaged 185 images (±113) and 66.2 minutes (±31.7) per CMN procedure.
• Entry point navigation consumed the most time (14 ±10.8 min) and images (49 ±42).
• This task showed significantly higher fluoroscopy use compared to all other analyzed tasks.

Conclusions:

• Resident fluoroscopy use in CMN fixation is substantial.
• Entry point navigation is a key area for potential fluoroscopy reduction.
• Targeted training on navigation techniques can improve radiation safety and efficiency.