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Radiation exposure to hand surgeons' hands: a practical comparison of large and mini C-arm fluoroscopy
Journal article   Peer reviewed

Radiation exposure to hand surgeons' hands: a practical comparison of large and mini C-arm fluoroscopy

Michael M Vosbikian, Asif M Ilyas, Derek D Watson and Charles F Leinberry
The Journal of hand surgery (American ed.), v 39(9), pp 1805-1809
01 Sep 2014
DOI: https://doi.org/10.1016/j.jhsa.2014.06.133
PMID: 25086796
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Fluoroscopy - instrumentation Hand - radiation effects Hand - surgery Humans Occupational Exposure Prospective Studies Radiation Dosage Radiation Monitoring - instrumentation Radiation Protection Surgeons
To determine and compare the radiation exposure to surgeons' hands with large and mini C-arm fluoroscopy in a practical, clinically based model. Two hand surgeons monitored radiation exposure to their hands with a ring dosimeter over a 14-month period using large and mini C-arm fluoroscopic units. One surgeon performed all cases with a large C-arm unit in a hospital setting, and the other performed all cases with mini C-arms in surgical centers. For each case, fluoroscopic time, the output displayed by the unit, radiation by time, and ring dosimeter absorption were recorded and analyzed. A total of 160 consecutive cases were reviewed with 71 cases and 89 cases in the large and mini C-arm groups, respectively. The median output displayed by the large C-arm was 0.7 mGy/case, and the median output displayed by the mini C-arm was 10.0 mGy/case. With output as a product of time, the median calculated values were 0.02 mGy/s for the large C-arm group and 0.28 mGy/s for the mini C-arm group. Cumulative ring dosimeter absorption to the surgeons' hands was found to be 380 mrem for 71 cases in the large C-arm group versus 1,000 mrem for 89 cases in the mini C-arm group. In our model, the use of the mini C-arm resulted in more than a 10-fold increase in the rate of output and approximately double the dosimeter absorption to the surgeon's hand compared with the large C-arm. Although it has been shown that the mini C-arm produces less radiation scatter, in a practical model, it may not be a safer alternative with respect to the surgeon's hands. Based on these findings, we recommend that surgeons be more aware of radiation exposure risk, know their C-arm unit's specifications, and try to minimize radiation exposure. Prognostic II.

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29 citations in Web of Science
32 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Surgery
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