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Trauma

LEADED EYEGLASSES SUBSTANTIALLY REDUCE RADIATION EXPOSURE OF THE SURGEON'S EYES DURING ACQUISITION OF TYPICAL FLUOROSCOPIC VIEWS OF THE HIP AND PELVIS

International Society for Fracture Repair (ISFR)



Abstract

Introduction

Radiation exposure to the eye causes cataracts. Few orthopaedists wear leaded glasses when using fluoroscopy despite regulatory limits for maximum annual eye exposure.

Methods

Using anthropomorphic patient and surgeon phantoms, radiation dose at the surgeon phantom's lens was measured with and without leaded glasses during fluroscopic acquisition of 16 common pelvic and hip views. The magnitude of lens dose reduction was calculated by dividing the unprotected dose by the dose measured behind leaded glasses.

Results

The unprotected lens dose varied considerably among the different views, ranging from 0 μRem for a single obturator oblique pelvic view, to 257 μRem for a single lateral sacral view with the image intensifier opposite the surgeon. On average, use of leaded glassess reduced radiation to the surgeon phantom's eye by 90%. The greatest reduction was seen with a crosstable lateral radiograph of the hip (22 μRem unprotected lens dose vs. 1 μRem with leaded glasses).

Conclusions

The use of leaded glasses could permit an orthopaedist to perform up to 10 times more cases before reaching the annual limit of 20 mSv (20 mSv = 2×106mRem). A large number of images are often required during a single operative procedure and varies greatly between cases. The number of cases which a surgeon can safely perform without leaded glasses is dependent on the number and type of images, and location of the surgeon with respect to the image intensifier.