Radiation exposure to the hands of orthopaedic surgeons: are we underestimating the risk?

IntroductionPrevious studies reported that the radiation exposure to the hands of orthopaedic surgeons was far below the acceptable limit. However, the risk could have been underestimated as some factors were overlooked, namely monitoring trainees during average workload, placing dosimeters over the most susceptible locations, measuring the cumulative dosage of radiation and considering the dose limit for non-classified workers.Materials and methodsWe performed a prospective study in two centres to estimate the radiation dose to the hands of two consultant trauma surgeons and two trainees (one assisting and one operating) while performing 47 fluoroscopy-assisted procedures. We used validated thermoluminescent dosimeters (TLDs) rings and fingerstalls for monitoring the cumulative dosage.ResultsTrainees were at higher risk while performing intramedullary nailing and during assistance. Higher radiation doses were recorded from dominant index fingers and particularly fingertips.ConclusionThe risk of radiation exposure appears to be higher than previously reported. Fingertips are more susceptible to radiation exposure and should therefore be monitored in forthcoming studies.

[1]  L. Swinburne Minerva , 1999, The Lancet.

[2]  G. McGill,et al.  Scattered radiation during fixation of hip fractures , 2001 .

[3]  A. Uçaner,et al.  Which one is at risk in intraoperative fluoroscopy? Assistant surgeon or orthopaedic surgeon? , 2003, Archives of Orthopaedic and Trauma Surgery.

[4]  T. Briggs,et al.  Radiation exposure of orthopaedic trainees: quantifying the risk. , 1996, Journal of the Royal College of Surgeons of Edinburgh.

[5]  R D Zura,et al.  A Transverse Acetabular Nonunion Treated with Computer-Assisted Percutaneous Internal Fixation. A Case Report* , 2000, The Journal of bone and joint surgery. American volume.

[6]  H. Whitfield,et al.  Radiation protection in percutaneous renal surgery. , 1992, British journal of urology.

[7]  E J van der Merwe,et al.  Exposure of surgeons-in-training to radiation during intramedullary fixation of femoral shaft fractures. , 1992, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[8]  S Stenzler,et al.  Exposure of the orthopaedic surgeon to radiation. , 1993, The Journal of bone and joint surgery. American volume.

[9]  P M Rommens,et al.  Radiation exposure to the hands and the thyroid of the surgeon during intramedullary nailing. , 1998, Injury.

[10]  T. Dipasquale,et al.  Radiation exposure to the orthopaedic surgical team during fluoroscopy: "how far away is far enough?". , 1997, Journal of orthopaedic trauma.

[11]  M. Davis,et al.  Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guidance for selected orthopaedic surgical procedures. , 1983, The Journal of bone and joint surgery. American volume.

[12]  Su-Young Bae,et al.  Radiation Exposure from Fluoroscopy during Orthopaedic Surgical Procedures , 2001 .

[13]  R. Putney,et al.  The Risk from Radiation Exposure during Operative X-ray Screening in Hand Surgery , 1994, Journal of hand surgery.

[14]  D. Jones,et al.  Radiation use in the orthopaedic theatre: a prospective audit. , 1998, The Australian and New Zealand journal of surgery.

[15]  S A Riley,et al.  Radiation exposure from fluoroscopy during orthopedic surgical procedures. , 1989, Clinical orthopaedics and related research.

[16]  B. Browner,et al.  Radiation exposure to the surgeon during closed interlocking intramedullary nailing. , 1987, The Journal of bone and joint surgery. American volume.

[17]  J. Cobb,et al.  Hazard of ionizing radiation to trauma surgeons: reducing the risk. , 1993, Injury.

[18]  K E Goldstone,et al.  Radiation exposure to the hands of orthopaedic surgeons during procedures under fluoroscopic X-ray control. , 1993, The British journal of radiology.

[19]  H. Storm,et al.  Radiation-induced acute myeloid leukaemia and other cancers in commercial jet cockpit crew: a population-based cohort study , 1999, The Lancet.