Röntgenstrahlenexposition in der Handchirurgie durch den
                    OrthoScan Mini-C-Arm: eine 1-Jahres Fallserie

Hohendorff, B.; Sauer, H; Biber, F.; Franke, Jörg; Müller, Lars Peter; Ries, Christian

doi:10.1055/a-0898-3618

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…Although studies suggest a decrease in radiation exposure with the use of the "mini C-arm," 24 compared with a standard C-arm, whenever possible the surgeon should use personal protection equipment including radiation shielding. Lead aprons and collars should always be worn by surgeons when using fluoroscopy, and the effectiveness of this simple measure has been demonstrated by multiple studies.…”

Section: C-arm Management and Positioningmentioning

confidence: 99%

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Patel

Judd

Harm

et al. 2022

J Am Acad Orthop Surg

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Orthopaedic surgeons are exposed to various occupational hazards in a busy daily practice which can cause potential physical injury and additional mental stress. By better understanding the hazards that are faced in the operating theater and the preventive measures that can be taken to avoid injury, orthopaedic surgeons can remain effective in their patient care duties. Infectious exposures, radiation exposure, noise pollution, chemical hazards, and physical demands are frequently encountered at the time of surgery and should be attenuated or avoided when possible. Simple preventive measures can prolong careers and protect the operating surgeon from musculoskeletal injuries and even solid organ damage and malignancy. Important consideration should be taken to recognize potential occupational hazards and act prophylactically before injury has occurred, and constant vigilance is required to avoid additive injury over time from physical and chemical insults. Level of Evidence: Level V O rthopaedic surgeons face many occupational hazards daily, and it is of paramount importance to be aware of and understand how to mitigate potential injuries. Total costs from all occupational injuries can exceed $190 billion annually in the United States inclusive of necessary health care and lost productivity. 1 Although not specific to orthopaedic surgeons, recent statistics highlight the dangers that surgeons face, indicating that work in a hospital setting may contribute to more nonfatal occupational injuries than even employment in construction or manufacturing. Indeed, of 313 total industries surveyed, the hospital industry ranks as the third most expensive when considering economic losses from occupational injuries. 2 General awareness and prevention of occupational safety among orthopaedic surgeons have increased in recent years, but there are many subtle occupational dangers that often go unnoticed and can be difficult to modify. Infectious exposure from sharp instruments or needles, physical insults such as radiation or noise pollution, and chemical exposure from inhalants or topical substances are some of the inherent hazards of participating in surgery. The purpose of this review article was to not only inform surgeons of these hazards Kishan Patel, DO Hyrum Judd, DO

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Section: C-arm Management and Positioningmentioning

confidence: 99%

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Patel

Judd

Harm

et al. 2022

J Am Acad Orthop Surg

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“…Several studies in the literature have examined the radiation exposure experienced by hand surgeons and/or operating room staff. [5][6][7][8][9] For example, van Rappard et al 9 measured whole-body, thyroid, and hand radiation exposure of surgeons who use mini c-arm fluoroscopy while performing hand and wrist procedures. They found that surgeon radiation levels were acceptable, averaging 2.9% of the yearly radiation limits for the body, 0.05% for the thyroid, and 2.56% for the hands.…”

mentioning

confidence: 99%

“…Surgeries of the hand and upper extremity commonly require the use of intraoperative fluoroscopy with the mini c-arm. Several studies in the literature have examined the radiation exposure experienced by hand surgeons and/or operating room staff 5–9 . For example, van Rappard et al 9 measured whole-body, thyroid, and hand radiation exposure of surgeons who use mini c-arm fluoroscopy while performing hand and wrist procedures.…”

mentioning

confidence: 99%

Investigating Patient-Level Radiation Exposure in Hand and Wrist Fracture Surgery

Christopher

Hu³

et al. 2022

Ann Plast Surg

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Background Although occupational exposure to radiation has been previously studied in the hand surgery literature, there is a paucity of studies looking at radiation exposure to the patient during fluoroscopy-guided hand surgery. We aimed to describe the level of radiation experienced by patients undergoing common hand and wrist fracture fixation and to identify risk factors for increased radiation exposure. Methods We performed a retrospective review of patients at a single institution who underwent fracture fixation of the hand, wrist, or forearm requiring mini c-arm fluoroscopic guidance from 2016 to 2020. Data points collected included patient demographics, procedural details, and indicators of radiation exposure including dose-area product (DAP), total intraoperative images, and total fluoroscopy time. Effective dose (ED) was calculated using DAP, field size, and a previously established conversion factor. Results The final sample included 361 patients with an average age of 46 years. Procedures included fixation of forearm fractures (3.3%), distal radius fractures (35.7%), metacarpal fractures (30.8%), and phalangeal fractures (30.2%). The median number of intraoperative images acquired was 36, median total fluoroscopy time was 43 seconds, median DAP was 4.8 cGycm2, and median ED was 0.13 μSv. Distal (metacarpal and phalangeal) fractures required more intraoperative images and longer total fluoroscopy time (49 images, 61 seconds) compared with proximal (forearm and distal radius) fractures (39 images, 47 seconds) (images, P = 0.004; exposure time, P = 0.004). However, distal fractures had a lower average ED compared with proximal fractures (0.15 vs 0.19 μSv, P = 0.020). When compared with open procedures, percutaneous procedures had higher DAPs (8.8 vs 4.9 cGycm2, P < 0.001), higher ED (0.22 vs 0.15 μSv, P < 0.001), more intraoperative images (65 vs 36 images, P < 0.001), and longer total fluoroscopy time (81.9 vs 44.4 seconds, P < 0.001). Conclusions Patient-level radiation exposure during fluoroscopy-guided hand and wrist procedures is low relative to other common imaging modalities, such as dental radiographs, chest x-rays, and computed tomography scans, and is comparable with less than a few hours of natural background radiation exposure, highlighting the overall safety of this important technology. Further study should be performed to establish reference ranges, which could lead to improved patient counseling and evidence-based guidelines on patient shielding.

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Röntgenstrahlenexposition in der Handchirurgie durch den OrthoScan Mini-C-Arm: eine 1-Jahres Fallserie

Cited by 2 publications

References 14 publications

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Investigating Patient-Level Radiation Exposure in Hand and Wrist Fracture Surgery

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