Abstract
Background
Radiation exposure remains a significant occupational hazard for Orthopaedic surgeons. There are no references values for trauma procedures performed with Image Intensifier (II). We aimed to determine and compare reference values for patient radiation exposure for common trauma operations, and to analyse the effect of surgeon grade on II usage.
Methods
Data collected prospectively from 849 cases between 01/05/2013 and 01/10/2014 were analysed. Statistical analysis was performed to calculate reference values for dose area product (DAP), screening time (ST), and number of II images taken for common trauma procedures where n>9 (n=808).
Results
Dynamic hip screw (DHS) fixation required significantly less radiation than proximal femoral nail (PFN) for intertrochanteric hip fractures for median DAP (668mG/cm2 vs 1040mG/cm2, p<0.001), ST (00:36 vs 00:48, p<0.001), and number of II images (65 vs 110, p<0.001). Radiation exposure was statistically significantly less when Consultant Orthopaedic surgeons were first surgeon compared to Staff grade doctors and Orthopaedic trainees for DAP (90.55mGy/cm2 vs 175.5mGy/cm2 vs 366.5mGy/cm2), screening time (00:26 vs 00:32 vs 00:36), and number of II images (49 vs 59 vs 66).
Conclusions
We reported reference values for common trauma operations that are essential to enable monitoring of patient radiation exposure. PFN required greater radiation exposure than DHS for intertrochanteric hip fracture. Increased surgical experience lead to lower radiation exposure in trauma operations, which could be developed to assess trauma competence within surgical training.
Level of evidence
III
