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Updated: Jan 9, 2026

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Radiation Exposure in Paediatric Orthopaedic Trauma Surgery

Kraig Jamieson1, Simon Barker2

  • 1Ophthalmology, Ninewells Hospital, Dundee, GBR.

Cureus
|December 8, 2025
PubMed

Insights

This study establishes local radiation exposure ranges for paediatric orthopaedic surgery, highlighting significant variability by procedure type. Findings support developing diagnostic reference levels (DRLs) for safer patient care.

Area of Science:

  • Medical Imaging
  • Paediatric Orthopaedics
  • Radiation Safety

Background:

  • Fluoroscopy is essential in paediatric orthopaedic surgery, but national radiation exposure benchmarks are absent.
  • Establishing local diagnostic reference levels (DRLs) is crucial for practice evaluation and patient safety.
  • This study quantifies intraoperative radiation exposure in common paediatric orthopaedic procedures.

Purpose of the Study:

  • To establish local reference ranges for intraoperative fluoroscopy radiation exposure.
  • To benchmark current radiation exposure practices in paediatric orthopaedic surgery.
  • To provide data supporting the development of national DRLs.

Main Methods:

  • Retrospective observational study of 480 paediatric (<18 years) orthopaedic procedures over four years.
  • Procedures categorized by anatomical region (elbow, ankle, pelvis) and type (MUA, MUA with K-wire, ORIF).
  • Fluoroscopy radiation exposure (mGy/cm²) recorded and analyzed using descriptive statistics and Mann-Whitney U tests.

Main Results:

  • Slipped upper femoral epiphysis (SUFE) pinning showed the highest mean exposure (384.5 mGy/cm²).
  • Open reduction and internal fixation (ORIF) had highest elbow exposure (13.9 mGy/cm²); MUA with K-wire fixation had highest ankle exposure (12.4 mGy/cm²).
  • MUA with K-wire procedures demonstrated significantly higher radiation exposure than simple MUA in elbow and ankle procedures (p < 0.001).

Conclusions:

  • This study provides the first detailed local reference ranges for intraoperative fluoroscopy in paediatric orthopaedics.
  • Significant procedure-specific variability in radiation exposure was observed.
  • Findings support the development of local DRLs, promoting safer practices and national standardisation.
Abstract

Keywords:
diagnostic reference levelsfluoroscopyorthopaedic procedurespaediatric orthopaedicsradiation exposure

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