Assessment of radiation exposure risks in patients undergoing elastic stable intramedullary nailing: Insights from intraoperative fluoroscopy

Assessment of radiation exposure risks in patients undergoing elastic stable intramedullary nailing: Insights from intraoperative fluoroscopy

Elastic stable intramedullary nailing (ESIN) is a well-defined and appropriate treatment of choice for long bone fractures. Despite its benefits, the risk of cancer from imaging devices is of particular concern for younger adults. So, this survey was conducted to estimate the doses administered to p...

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Bibliographic Details
Published in:Radiography (London, England. 1995) Vol. 30; no. 4; pp. 1225 - 1231
Main Authors: Safari, A., Falahati, F., Bahaedini, N., Fardid, R., Mesbahi, S.E.
Format: Journal Article
Language:English
Published: Netherlands Elsevier Ltd 01-07-2024
Subjects:
Adult
Aged
Bone Nails
Cancer risk
Effective dose
Elastic stable intramedullary nailing
Female
Femoral Fractures - diagnostic imaging
Femoral Fractures - etiology
Femoral Fractures - surgery
Fluoroscopy
Fracture Fixation, Intramedullary - methods
Humans
Intraoperative radiation
Male
Middle Aged
Monte Carlo Method
Neoplasms, Radiation-Induced - etiology
Radiation Dosage
Radiation Exposure
Risk Assessment
Tibial Fractures - diagnostic imaging
Tibial Fractures - surgery
Young Adult
Effective dose
Intraoperative radiation
Elastic stable intramedullary nailing
Cancer risk
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Summary:Elastic stable intramedullary nailing (ESIN) is a well-defined and appropriate treatment of choice for long bone fractures. Despite its benefits, the risk of cancer from imaging devices is of particular concern for younger adults. So, this survey was conducted to estimate the doses administered to patients undergoing ESIN of long bone fractures utilizing a 2-dimensional (2D) C-arm fluoroscopy machine during surgery, as well as the carcinogenic risk associated with the use of the machine. This study was conducted on 147 patients who required ESIN for long-bone fractures. Patients' demographic data, surgical data and imaging information were collected. For each patient, the organ doses and the effective doses were computed with the Monte Carlo PCXMC 2.0 simulation software. The cancer risk models proposed in the Biological Effects of Ionizing Radiation VII (BEIR VII) Phase 2 report were used to evaluate the risk of exposure-induced cancer death (REID) values. For all patients, the highest organ dose was delivered to the gonads. The mean effective dose was 0.026 ± 0.015 mSv and 1.3E-04 ± 1E-04 mSv for ESIN of femur and tibia fractures, respectively. Males had a mean REID of 1 per million, while females had a mean REID of 0.19 per million. The younger males had considerably higher REID values. The effective dose was significantly correlated with age, gender, and irradiation time. Low levels of effective doses and cancer risks associated with the utilization of the fluoroscopy machine in current practice were found in ESIN treatment of long-bone fractures. This outcome will help to raise surgeons' awareness of radiation risks and encourage them to initiate measures to keep radiation dose and exposure time as low as reasonably achievable.
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ISSN:1078-8174
1532-2831
1532-2831
DOI:10.1016/j.radi.2024.06.008