Real-time dosimetry reduces radiation exposure of orthopaedic surgeons

Background: Cancer prevalence of orthopaedic surgeons is elevated and chronic exposure to occupational ionizing radiation is seen as one reason. Hypothesis: Use of a new dosimeter enabling radiation dose monitoring in real-time may reduce radiation exposure of orthopaedic surgeons. Materials and methods: Over a period of four months, the surgeon and the C-arm operator were equipped with a novel dosimeter called DoseAware (R) (DA) while using the C-arm fluoroscope intraoperatively. Data of 68 patients DA were retrospectively compared using matched-pair analysis with 68 controls without DA. Both groups were assessed regarding fluoroscopic time (FT) and radiation dose (RD). Seven types of operative procedures were performed: internal fixation of subcapital humerus fractures, midshaft clavicular fractures, distal radius fractures, pertrochanteric femoral fractures, ankle fractures, traumatic vertebral fractures and osteoporotic vertebral fractures. Results: Concerning the FT, use of DoseAware (R) led to a significant reduction for all evaluated operation types except for internal fixation of distal radius fractures (P=0.0511). Regarding the RD, use of DoseAware (R) led to a significant reduction for all evaluated operation types except trochanteric femoral fractures with a PFNA (R) (P= 0.0841). Conclusion: DoseAware (R) allowing real-time radiation dose monitoring reduces radiation exposure of the orthopaedic surgeon and instantly demonstrates the effects of dose-reduction techniques. Level of evidence: Level III retrospective case control study. (C) 2014 Elsevier Masson SAS. All rights reserved.