Dosimetry during intramedullary nailing of the tibia: Patient and occupational exposure

Background Intramedullary nailing under fluoroscopic guidance is a common operation. We studied the intraoperative radiation dose received by both the patient and the personnel. Patients and methods 25 intramedullary nailing procedures of the tibia were studied. All patients suffered from tibial fra...

Full description

Saved in:
Bibliographic Details
Published in:Acta orthopaedica 2009-10, Vol.80 (5), p.568-572
Main Authors: Kirousis, George, Delis, Harry, Megas, Panagiotis, Lambiris, Elias, Panayiotakis, George
Format: Article
Language:English
Subjects:
Applied radiobiology (equipment, dosimetry...)
Biological and medical sciences
Biological effects of radiation
Diseases of the osteoarticular system
Fundamental and applied biological sciences. Psychology
Medical sciences
Orthopedic surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tissues, organs and organisms biophysics
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Intramedullary nailing under fluoroscopic guidance is a common operation. We studied the intraoperative radiation dose received by both the patient and the personnel. Patients and methods 25 intramedullary nailing procedures of the tibia were studied. All patients suffered from tibial fractures and were treated using the Grosse-Kempf intramedullary nail, with free-hand technique for fixation of the distal screws, under fluoroscopic guidance. The exposure, at selected positions, was recorded using an ion chamber, while the dose area product (DAP) was measured with a DAP meter, attached to the tube head. Thermoluminescent dosimeters (TLDs) were used to derive the occupational dose to the personnel, and also to monitor the surface dose on the gonads of some of the patients. Results The mean operation time was 101 (48-240) min, with a mean fluoroscopic time of 72 seconds and a mean DAP value of 75 cGy·cm 2 . The surface dose to the gonads of the patients was less than 8.8 mGy during any procedure, and thus cannot be considered to be a contraindication for the use of this technique. Occupational dose differed substantially between members of the operating personnel, the maximum dose recorded being to the operator of the fluoroscopic equipment (0.11 mSv). Interpretation Our findings underscore the care required by the primary operator not to exceed the dose constraint of 10 mSv per year. The rest of the operating personnel, although they do not receive very high doses, should focus on the dose optimization of the technique.
ISSN:1745-3674
1745-3682
DOI:10.3109/17453670903350057