The need to protect the thyroid gland during image intensifier use in orthopaedic procedures.

The image intensifier has become an essential part of the orthopaedic surgeon's armamentarium. Its increasing use, however, may expose medical staff and theatre personnel to high doses of radiation. The aim of this study was to assess the compliance of surgeons and staff with radiation protection protocols, especially the use of the thyroid shield and to calculate the radiation exposure dose during routine orthopaedic procedures. We carried out this prospective study of 44 consecutive cases at the Rochdale Infirmary. The total dose of radiation and the total number of images taken were found to be more during hip surgery such as dynamic hip screw fixation for intertrochanteric fracture (1,715.5 mGy.cm2) and the intramedullary nailing (4,357.5 mGy.cm2). However the total percentage of the theatre personnel wearing thyroid shield was as low as 4% (14 people out of total 345 people present in theatre in 44 procedures) in spite of its availability. The consistent neglect in the use of the thyroid shield by surgeons and nursing staff present in theatre during fluoroscopically assisted procedures is a matter for concern. The data presented in this study will emphasise the need to wear a thyroid collar during orthopaedic procedures and the need for better guidelines to protect theatre personnel as well as patients from radiation exposure hazards.