Fluoroscopy Exposure During Distal Radius Fracture Fixation: An Audit of Current Practice

Area of Science:

• Orthopaedic Surgery
• Radiology
• Medical Physics

Background:

• Distal radius fractures (DRFs) are common adult fractures often treated with volar plate fixation.
• Intraoperative fluoroscopy is crucial for DRF surgery but poses radiation risks to patients and staff.
• Assessing local practice and radiation exposure is vital for establishing safety benchmarks.

Purpose of the Study:

• To evaluate local practices for intraoperative fluoroscopy in DRF fixation.
• To quantify radiation exposure parameters, including screening time and dose area product (DAP).
• To inform the establishment of national benchmarks for fluoroscopy use and radiation safety.

Main Methods:

• Retrospective review of 106 patients undergoing volar plate fixation for DRFs.
• Collection of demographics, fracture types, surgical details, and fluoroscopy parameters (screening time, exposures, DAP, air kerma).
• Analysis of data stratified by fracture type and surgeon grade.

Main Results:

• Mean screening time was 24 seconds, with a mean DAP of 4.75 µGy·m².
• Mean number of exposures was 43, and mean air kerma (AK) was 0.26.
• No significant differences in radiation exposure were found based on surgeon grade or fracture complexity.

Conclusions:

• Intraoperative fluoroscopy for DRFs yields specific radiation exposure levels (mean DAP 4.75 µGy·m², mean screening time 24s).
• Operator grade and fracture complexity did not significantly impact radiation exposure.
• Standardizing data collection and defining diagnostic reference levels are recommended for improving safety and uniformity across institutions.