Literature DB >> 27390561

Radiation Exposure and Hand Dominance Using Mini C-Arm Fluoroscopy in Hand Surgery.

Corey B Fuller1, Montri D Wongworawat1, Barth B Riedel1.   

Abstract

BACKGROUND: The mini C-arm is popular with hand surgeons, and they are particularly at risk for radiation exposure, as they cannot easily distance themselves from the radiation beam. We hypothesized that the nondominant hand receives more radiation exposure than the dominant hand as it is generally closer to the radiation source. This study seeks to determine whether a hand surgeon receives a different amount of radiation exposure to their hands based on hand dominance and then accounting for this, provide a more accurate assessment of hand radiation exposure from mini C-arm fluoroscopy.
METHODS: Two fellowship-trained hand surgeons wore ring dosimeters on both hands during surgeries with mini C-arm fluoroscopy involving bony work of the forearm and hand. Radiation exposure to the hands was measured from ring dosimeters.
RESULTS: Six-ring dosimeter pairs were worn during 64 cases, averaging 10.7 cases per ring. No ring met the minimal dose threshold of 30 mrem to record a numerical value. Each ring experienced an average of 413 seconds of fluoroscopy time and 66.3509 cGy*cm(2) of radiation output from the mini C-arm.
CONCLUSIONS: The results do not allow comparison of radiation exposure related to hand dominance. Assuming worst-case scenario: each ring measured 29 mrem (just below the threshold), the surgeon's hands experienced 2.7 mrem per case. This would allow a hand surgeon to perform 18 391 cases per year before exceeding the allowable annual hand exposure limit of 50 000 mrem set by the National Council of Radiation Protection and Measurements and International Commission on Radiological Protection.

Keywords:  fluoroscopy; hand surgery; mini c-arm; radiation

Year:  2016        PMID: 27390561      PMCID: PMC4920527          DOI: 10.1177/1558944715627224

Source DB:  PubMed          Journal:  Hand (N Y)        ISSN: 1558-9447


  20 in total

1.  Occupational exposure from common fluoroscopic projections used in orthopaedic surgery.

Authors:  Nicholas Theocharopoulos; Kostas Perisinakis; John Damilakis; George Papadokostakis; Alexander Hadjipavlou; Nicholas Gourtsoyiannis
Journal:  J Bone Joint Surg Am       Date:  2003-09       Impact factor: 5.284

2.  Radiation protection issues with the use of mini C-arm image intensifiers in surgery in the upper limb. Optimisation of practice and the impact of new regulations.

Authors:  S Sinha; S J Evans; M K Arundell; F D Burke
Journal:  J Bone Joint Surg Br       Date:  2004-04

3.  Radiation exposure with use of the mini-C-arm for routine orthopaedic imaging procedures.

Authors:  Brian L Badman; Lynn Rill; Bradley Butkovich; Manuel Arreola; Robert A Vander Griend
Journal:  J Bone Joint Surg Am       Date:  2005-01       Impact factor: 5.284

4.  Radiation exposure in hand surgery: mini versus standard C-arm.

Authors:  George S Athwal; Reuben A Bueno; Scott W Wolfe
Journal:  J Hand Surg Am       Date:  2005-11       Impact factor: 2.230

5.  Radiation exposure of the hands and thyroid gland during percutaneous wiring of wrist and hand procedures.

Authors:  Syah Bahari; Seamus Morris; David Broe; Colm Taylor; Brian Lenehan; John McElwain
Journal:  Acta Orthop Belg       Date:  2006-04       Impact factor: 0.500

6.  Exposure from the large C-arm versus the mini C-arm using hand/wrist and elbow phantoms.

Authors:  Gordon Singer; Brent Herron; David Herron
Journal:  J Hand Surg Am       Date:  2011-04       Impact factor: 2.230

7.  Increased cancer risk among surgeons in an orthopaedic hospital.

Authors:  Giuseppe Mastrangelo; Ugo Fedeli; Emanuela Fadda; Angelo Giovanazzi; Luca Scoizzato; Bruno Saia
Journal:  Occup Med (Lond)       Date:  2005-09       Impact factor: 1.611

8.  Exposure of the orthopaedic surgeon to radiation.

Authors:  R Sanders; K J Koval; T DiPasquale; G Schmelling; S Stenzler; E Ross
Journal:  J Bone Joint Surg Am       Date:  1993-03       Impact factor: 5.284

9.  Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guidance for selected orthopaedic surgical procedures.

Authors:  M E Miller; M L Davis; C R MacClean; J G Davis; B L Smith; J R Humphries
Journal:  J Bone Joint Surg Am       Date:  1983-01       Impact factor: 5.284

10.  Radiation-induced carcinoma of the hand.

Authors:  J Bunkis; A I Mehrhof; J W Stayman
Journal:  J Hand Surg Am       Date:  1981-07       Impact factor: 2.230

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