Michael D Baratz1, Yue-Yung Hu2, David Zurakowski3, Paul Appleton4, Edward K Rodriguez5. 1. Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: mbaratz@gmail.com. 2. Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: yhu@bidmc.harvard.edu. 3. Department of Anesthesia, Children's Hospital Boston, Boston, MA, United States. Electronic address: David.Zurakowski@childrens.harvard.edu. 4. Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: pappleto@bidmc.harvard.edu. 5. Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: ekrodrig@bidmc.harvard.edu.
Abstract
OBJECTIVES: To establish the primary determinants of operative radiation use during fixation of proximal femur fractures. DESIGN: Retrospective cohort study. SETTING: Level I trauma centre. COHORT: 205 patients treated surgically for subtrochanteric and intertrochanteric femoral fractures. MAIN OUTCOME MEASURES: Fluoroscopy time, dose-area-product (DAP). RESULTS: Longer fluoroscopy time was correlated with higher body mass index (p=0.04), subtrochanteric fracture (p<0.001), attending surgeon (p=0.001), and implant type (p<0.001). Increased DAP was associated with higher body mass index (p<0.001), subtrochanteric fracture (p=0.002), attending surgeon (p=0.003), lateral body position (p<0.001), and implant type (p=0.05). CONCLUSION: The strongest determinants of radiation use during surgical fixation of intertrochanteric and subtrochanteric femur fractures were location of fracture, patient body position, patient body mass index, and the use of cephalomedullary devices. Surgeon style, presumably as it relates to teaching efforts, seems to strongly influence radiation use.
OBJECTIVES: To establish the primary determinants of operative radiation use during fixation of proximal femur fractures. DESIGN: Retrospective cohort study. SETTING: Level I trauma centre. COHORT: 205 patients treated surgically for subtrochanteric and intertrochanteric femoral fractures. MAIN OUTCOME MEASURES: Fluoroscopy time, dose-area-product (DAP). RESULTS: Longer fluoroscopy time was correlated with higher body mass index (p=0.04), subtrochanteric fracture (p<0.001), attending surgeon (p=0.001), and implant type (p<0.001). Increased DAP was associated with higher body mass index (p<0.001), subtrochanteric fracture (p=0.002), attending surgeon (p=0.003), lateral body position (p<0.001), and implant type (p=0.05). CONCLUSION: The strongest determinants of radiation use during surgical fixation of intertrochanteric and subtrochanteric femur fractures were location of fracture, patient body position, patient body mass index, and the use of cephalomedullary devices. Surgeon style, presumably as it relates to teaching efforts, seems to strongly influence radiation use.
Authors: Kapil Sugand; Robert A Wescott; Richard Carrington; Alister Hart; Bernard H Van Duren Journal: Acta Orthop Date: 2018-05-10 Impact factor: 3.717