Radiation risk amongst orthopaedic surgeons and theatre personnel is increasing with increased use of fluoroscopy imaging. Increased radiation risk has been shown to be associated with an increased risk of malignancies, ocular and thyroid disorders. Very high exposures have been reported in spinal surgery and during intra-medullary nailing. With an increase in modern and percutaneous methods, the use of intra-operative fluoroscopy has increased as well. The aim of this article was to review the available evidence of radiation risk amongst healthcare personnel. A systematic search was carried out in PubMED, CINAHL and Cochrane on intra-operative radiation in trauma and orthopaedic operating room. Inclusion criteria were clinical studies and systematic reviews reporting on radiation exposure, fluoroscopy time and references to specific safety guidelines. This article highlights the safety aspects of radiation protection and harmful effects of radiation during orthopaedic procedures. The responsibility to minimise radiation exposure in operating theatre lies with the team within the operating room.

Metaphyseal corner fractures (MCFs) in infants are strongly associated with inflicted injuries. These fractures occur due to shearing forces and involve the chondro-osseous junction in skeletally immature bones. We present the unique case of a MCF of the distal femur caused in utero by external cephalic version (ECV). The illustration of this case links the mechanism to the injury. It is critical for this mechanism to be understood to prevent an erroneous diagnosis of child abuse.