Background In spite of frequent exposure to radiation, orthopaedic surgeons lack knowledge about radiation safety and do not comply with safety practices. We surveyed orthopaedic trainees and consultants in India to determine their knowledge and practices regarding radiation safety. Methods A questionnaire with 16 multiple choice questions was sent out using Google forms. We included practicing orthopaedic surgeons (consultants), fellows and trainees pursuing DNB, MS and D. Ortho courses across India. ResultsWe received 439/700 responses (62.7% response rate) from 233 (53.1%) consultants and 206 (46.9%) trainees. Only 71 (16.2%) were aware of the ALARA (As Low As Reasonably Achievable) principle. While lead aprons were always used by 379 (86.3%), thyroid shields were never used by 302 (68.8%) respondents. Knowledge about the ALARA principle was significantly associated with radiation safety practices. A significantly greater proportion of participants who were aware about the ALARA principle always used lead aprons (OR 1.15; 95% CI 1.0 to 1.2, p = 0.001) and thyroid shields (OR 2.00; 95% CI 1.0 to 3.7, p = 0.029) and had their dosimeters checked within the last 1 year (OR 1.69; 95% CI 1.0 to 2.8, p = 0.039) when compared to those who were not aware of the ALARA principle. Almost 99% respondents expressed interest in participating in a radiation safety training program. Conclusion A majority of the respondents were keen to obtain training in radiation safety. We believe that professional organizations and hospitals could initiate training programs for the orthopaedic community in India to improve their radiation safety knowledge and practices.
A displaced supracondylar humerus in a child is usually treated with closed reduction and percutaneous Kirschner (K)-wire fixation. The procedure is straightforward and usually yields excellent outcomes. In general, intraoperative complications are uncommon and intraoperative complications related to K-wires are exceedingly rare. We present the case of intraoperative K-wire breakage while performing closed reduction and K-wire fixation for a pediatric supracondylar humerus fracture. This unusual complication occurred while drilling through the medial cortex and the broken end of the K-wire disappeared under the skin in the cartilaginous distal humerus. The broken wire was removed by making an incision over the broken end. This report serves as a reminder to follow principles of drilling and avoid K-wire-related complications while performing percutaneous fixation of the pediatric supracondylar humerus fracture.
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