Radiation exposure to surgeon and patient in intramedullary nailing of the lower limb

Madan, Sanjeev; Blakeway, C.

doi:10.1016/s0020-1383(02)00042-6

Cited by 81 publications

(47 citation statements)

References 14 publications

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“…Despite ease in performance operative treatment exposes the patient longer to radiation compared to nonoperative treatment. The mean radiation time of 2 min 14 s in the present study is remarkably longer compared to the data published by Madan & Blakeway [11]. In addition, Madan's & Blakeway's investigation showed that the average radiation time when done by consultants was half that of middle-grade surgeons; information about the person handling the fluoroscopy device was not provided in their study.…”

Section: Discussioncontrasting

confidence: 73%

Elastic Stable Intramedullary Nailing (ESIN) in Lower Leg Fractures

et al. 2005

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European Journal of Trauma Ab stractPurpose: This study analyzes the results of elastic stable intramedullary nailing (ESIN) of the lower extremity in children and possible complications of this method. Patients and Methods: The data of 47 pediatric patients (38 male, nine female, mean age 9.8 years, range 1-16 years) treated from 2001 to 2003 with ESIN of the lower leg at the and Regensburg, Germany, were reviewed. Children with isolated tibia fractures as well as children with fractures of tibia and fibula were included. In all children the implants were inserted antegrade followed by cast-free mobilization. Results: The majority (77%) of the children were operated on within 1 day after trauma. Mean duration of surgery was 58 min (range 20-140 min), mean hospital stay 8.9 days (range 2-20 days). Full weight bearing was achieved within 12 up to 87 days (mean 46 days) after trauma. Implants were removed after radiologically proven fracture consolidation (mean 188 days after implantation). Trauma-related complications (n = 7; 15%) were compartment syndrome necessitating fasciotomy in four patients; osteomyelitis, peroneus paresis and refracture were reported in one child each. Surgical complications were present in four children (9%): pseudarthrosis (inadequate implants), wound infection at the implantation site, implant dislocation (unstable fixation) and fracture dislocation (distal fracture) occurred in one child each. Finally, all fractures healed in good alignment. Conclusion: High-energy trauma of the lower leg is associated with a significant rate of trauma-related complications. Compliance with guidelines for indication and technique may prevent surgical complications.

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Section: Discussioncontrasting

confidence: 73%

Elastic Stable Intramedullary Nailing (ESIN) in Lower Leg Fractures

et al. 2005

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“…According to US evaluations, median AV angle difference between injured and uninjured sides was found to be 5.00±2.97 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) in group 1 and 5.00±3.34 (0-17) in group 2 (p=0.690). There was no statistically significant difference between AV angles of injured and uninjured sides of the patients in both groups ( Table 1) (p>0.05).…”

Section: Resultsmentioning

confidence: 96%

“…Distal locking is the most challenging part of the antegrade IMN procedure and it is associated with prolonged operation time and more radiation exposure. Per IMN, the surgeon receives a mean radiation dose of 0.33 mSv [12]. In antegrade femoral IMN, proximal locking is performed through a guide attached to the insertion handle, whilst distal locking is performed using a free-hand technique under fluoroscopic guidance.…”

Section: Introductionmentioning

confidence: 99%

Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?

Çiftdemir

Tuncel

Özcan

et al. 2014

International Orthopaedics (SICOT)

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“…6,7 The range of operative procedures requiring image intensifier screening has led to an interest by orthopaedic surgeons in their exposure to ionising radiation. [8][9][10][11] Studies have considered exposure during experimental operation set-ups on phantom patients, 12 during common trauma operations, [13][14][15] for different locations and personnel in the operating theatre, [16][17][18] for different parts of the body, 19 and also investigating methods to reduce exposure. 20,21 There is evidence, however, that actual practice of basic ionising radiation protection varies widely.…”

mentioning

confidence: 99%

Ionising Radiation Exposure to Orthopaedic Trainees: The Effect of Sub-Specialty Training

Oddy

Aldam

2006

annals

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INTRODUCTION We monitored image intensifier use by orthopaedic trainees to assess their exposure to ionising radiation and to investigate the influence of sub-specialty training.MATERIALS AND METHODS Five different orthopaedic registrars recorded their monthly image intensifier screening times and exposure doses for all cases (trauma and elective), for a combined total of 12 non-consecutive months. Radiation exposure was monitored using shoulder and waist film badges worn both by surgeons and radiographers screening their cases.RESULTS Registrars in spinal sub-specialties were exposed to significantly higher doses per case and cumulative doses per month than non-spinal trainees (P < 0.05), but significantly lower screening times per case (P < 0.05). There were no significant differences in cumulative screening times per month (P > 0.05). Regression analysis for all surgeons showed a significant relationship between shoulder film badge reading and cumulative dose exposed per month (P < 0.05), but not for cumulative screening time. Shoulder film badge recordings were significantly higher for spinal compared with non-spinal registrars (P < 0.05), although all badges were below the level for radiation reporting. Only one radiographer badge recorded a dose above threshold.CONCLUSIONS Whilst the long-term effects of sub-reporting doses of radiation are not fully understood, we consider that this study demonstrates that trainees should not be complacent in accepting inadequate radiation protection. The higher doses encountered with spinal imaging means that sub-specialty trainees should be alerted to the risk of their increased exposure. The principle of minimising radiation exposure must be maintained by all trainees at all times.

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Radiation exposure to surgeon and patient in intramedullary nailing of the lower limb

Cited by 81 publications

References 14 publications

Elastic Stable Intramedullary Nailing (ESIN) in Lower Leg Fractures

Elastic Stable Intramedullary Nailing (ESIN) in Lower Leg Fractures

Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?

Ionising Radiation Exposure to Orthopaedic Trainees: The Effect of Sub-Specialty Training

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