Fluoroscopy Use and Radiation Exposure in Distal Radius Fracture Fixation

Area of Science:

• Orthopedic Surgery
• Radiology
• Patient Safety

Background:

• Quantifying intraoperative radiation exposure during distal radius fracture (DRF) surgical fixation is crucial for patient and staff safety.
• Identifying factors contributing to fluoroscopic use is essential for optimizing radiation dose reduction strategies.

Purpose of the Study:

• To quantify radiation exposure during surgical fixation of DRF.
• To identify patient and surgeon-related factors associated with increased intraoperative fluoroscopic use.

Main Methods:

• Retrospective analysis of 342 patients undergoing acute DRF surgical fixation (2017-2019).
• Data collected included patient demographics, surgeon characteristics, and fluoroscopy parameters (dose area product, image count, fluoroscopy time).
• Univariate and bivariate statistical analyses were performed to identify significant associations (P<0.05).

Main Results:

• Median patient age was 59 years, with 77.8% females.
• Median radiation dose area product (DAP) was 9.24 cGy*cm², with a median of 36 images and 60 seconds of fluoroscopy time per case.
• Higher radiation exposure correlated with male patients, complex fracture patterns, implant choice, less experienced surgeons, surgeon subspecialty, and trainee involvement.

Conclusions:

• Intraoperative fluoroscopy use in DRF fixation is influenced by injury characteristics and surgeon-related factors.
• Male sex, complex fracture morphology, surgeon experience level, and the presence of trainees are associated with increased fluoroscopic utilization and radiation exposure.