Comparison of fluoroscopy time in short and long cephalomedullary nailing for 31A2 intertrochanteric hip fractures

There is no study that has compared the radiation exposure during short (Short PFN) and long proximal femoral nailing (Long PFN) for 31A2 intertrochanteric hip fractures. The objective of the present study was to compare the radiation exposure time in short and long proximal femoral nail during the treatment of 31A2 intertrochanteric hip fractures. This prospective cohort study was carried out in a University teaching hospital. Sixty one consecutive patients with 31A2 intertrochanteric femur fracture treated with pro- ximal femoral nail were included in the study. The distal locking in the short PFN was performed using the locking zig and distal locking in the long PFN was performed using the free hand perfect circle technique. The same mobile image intensifier (Multimobil 5E, Siemens, Erlangen, Germany) was used in the entire study. The outcome measure was the fluoroscopy exposure time (seconds) which was measured directly from the image intensifier. Thirty patients underwent fixation with short PFN and 31 patients underwent fixation using long PFN. The mean fluoroscopy exposure time in short PFN cohort was 189.5 seconds ± 26 (range : 150-250 seconds) and the mean fluoroscopy exposure time in long PFN cohort was 283.4 seconds ± 43.8 (range : 200-400 seconds). The mean fluoroscopy exposure time was 93.9 seconds shorter in the short PFN cohort and this difference was statistically significant (p < 0.0001 ; 95% CI : 75.4 to 112.3). The radiation exposure to the operating team is significantly less during treatment with short PFN in 31A2 intertrochanteric fractures.

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Comparing Effectiveness Between a Power-Drill-Mounted Device and Conventional Free-Handed Technique for Distal Locking of Intramedullary Implants

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00229 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0022

Author(s):

Supachoke Wattanakitkrileart ◽

Boonsin Tangtrakulwanich ◽

Varah Yuenyongviwat

Keyword(s):

Radiation Exposure ◽

Exposure Time ◽

Operative Time ◽

Operating Time ◽

Surgical Team ◽

Intramedullary Nails ◽

Distal Locking ◽

Orthopedic Surgeons ◽

Power Drill ◽

Intramedullary Implants

Objectives: The procedure for distal locking of intramedullary nails (IM nail) is one of the time-consuming procedures and also exposes the surgical team and patient to high levels of radiation. Many techniques and devices have been created to solve the problems. Nonetheless, conventional free-hand technique is still the most popular due to easy-to-use and no added device needed. This research aims to study the accuracy of a drill-mounted device with free-handed technique in the distal locking of IM nail procedure. Methods: This is an experimental study. The device was made from PVC pipes. In this study, IM-nail-inserted synthetic femoral bones (Synbone®) were set as in IM nail procedure. Four orthopedic surgeons were instructed and performed the distal locking procedure with free-handed technique and then with the device (totally 20 times for each technique). The radiation exposure time and operating time were recorded. Results: The drill-mounted device reduced the radiation exposure time statistically significant lower than the free-handed technique. However, there was no different in operative time between the two techniques. Screw misdirection occurred two times in free-handed technique but not found in our device-assisted group. Conclusion: In this experiment, the new-designed device can reduce the radiation exposure time in distal IM nail interlocking procedure. Nonetheless, further clinical study is required to confirm our results.

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Assessment of ionizing radiation exposure levels and associated health risk in some selected solid mineral mining sites Edo-North, Nigeria

Scientia Africana ◽

10.4314/sa.v19i3.11 ◽

2021 ◽

Vol 19 (3) ◽

pp. 153-166

Author(s):

A.O. Eshiemomoh ◽

G.O. Avwiri ◽

C.P. Ononugbo

Keyword(s):

Cancer Risk ◽

Ionizing Radiation ◽

Radiation Exposure ◽

Dose Rate ◽

Exposure Rate ◽

Lifetime Cancer Risk ◽

Entire Study ◽

Mining Sites ◽

The Mean ◽

Ionizing Radiation Exposure

Ionizing radiation exposure rate and its associated health risks were assessed using Digilert 200 and Rados Radiation Monitoring Meter, integrated with Geographical Positioning System (Garmin GPSMAP 76S) of some selected solid mineral mining sites across Edo-North Nigeria. The mean exposure rates show some characteristic range of 0.010±0.005 𝑚𝑅ℎ𝑟−1 to 0.027 𝑚𝑅ℎ𝑟 −1 across the entire study. The obtained mean exposures rates at all the mining pits were higher than the ICRP standard limit of 0.013 𝑚𝑅ℎ𝑟 −1 , except at freedom limestonesmining pit where we recorded 0.010 mRh-1. It was also observed that limestones mining sites exhibited low exposure rate while granite mining sites exhibited high exposure rate. The computed equivalent dose rate ranges from 1.049 mSvy-1 to 2.287 mSvy-1 , which is well above the recommended permissible limit of 1.0 mSvy-1 for the general public. 91.7% of the mining sites recorded higher absorbed dose rate but the mean AEDE recorded across the entire study area are below the ICRP standard. The average excess lifetime cancer risk shows variation from 0.472 x 10-3 to 1.27 x 10-3 . . By this result, the probability of contacting cancer due to radiation exposure is higher in places like Cinoma pit, Cetraco pit, Niger-Cat pit, Jigom pit, Oaries pit and Petra-Quarries pit. Keywords: Assessment, Mining pits, Background, Exposure, lifetime cancer risk

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’Endoscopy assisted distal locking of intramedullary nail’, a new experimental technique to reduce the radiation exposure during the distal locking of the intramedullary nails.

10.21203/rs.3.rs-203296/v1 ◽

2021 ◽

Author(s):

Serkan Davut ◽

Yunus Doğramacı

Keyword(s):

Radiation Exposure ◽

Exposure Time ◽

Shaft Fracture ◽

Long Bone ◽

Control Group ◽

Study Group ◽

Distal Locking ◽

Time Period ◽

Group 10 ◽

Time Required

Abstract Introduction: The gold standart for treating a lower extremity long bone shaft fracture is closed reduction and internal fixation using the locking intramedullary nailing. The fracture is stable if the nail is locked distally and proximally. Usually all the aiming devices are successfull to lock the proximal but not with the distal screws. Distal locking step is the main source for radiation exposure during this type of surgery. In this study we tried to reduce the radiation exposure using an intra-nail endoscopic visualisation and illumination method for distal locking.Methods: 20 fresh bovine tibia bone were included in this study. Two groups each with 10 samples were prepared. We applied a standart nailing process in both groups, the study group (10 sample) locked by the new technic ''Intranail endoscopic illumination and visualisation locking method'' and the control group (10 sample) were locked by the free hand fluoroscopic guidance technic. We measured the surgical period time and the radiation exposure time required for distal locking procedure in both groups.Results: The radiation exposure time was statistically significantlly lower in the study group comparing to the control group. Also the time period required for distal locking in the study group were statistically significantly lower than the control group.With the use of the intranail endoscopic illumination guidance and visualisation assistance technic, the mean period time required for distal locking procedure reduced from 477,5 to 223,5 seconds (p < 0,001). The radiation exposure dramatically reduced from 13,5 to 2 seconds (p < 0,001 ). The attempt number reduced from 6,5 to 2 times (p < 0,001).Conclusions: This study showed that using a simple intranail endoscopic visualisation and illumination guidance will make the distal locking step safer by reducing the radiation exposure time and also reduce the surgical period.

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A novel patient-specific three-dimensional printing template based on external fixation for pelvic screw insertion

10.21203/rs.3.rs-36492/v1 ◽

2020 ◽

Author(s):

kaihua Zhou ◽

Xingguang Tao ◽

Fugen Pan ◽

Congfeng Luo ◽

Huilin Yang

Keyword(s):

Radiation Exposure ◽

External Fixation ◽

Exposure Time ◽

Patient Specific ◽

Mean Deviation ◽

Surgical Time ◽

X Ray ◽

Screw Insertion ◽

Navigation Group ◽

The Mean

Abstract (1) Background: To investigate the clinical effect of the novel patient-specific 3D printing templates based on external fixation for pelvic screw insertion. (2) Methods: We retrospectively studied 8 patients with pelvic fractures who were treated using this novel template from July 2017 to July 2018. During the operation, the screws were inserted with the aid of the template. The operative time per screw, radiation exposure time, and accuracy of the screw insertions as evaluated by post-operative CT scans were analyzed statistically and compared with previous outcomes using the fluoro-navigation technique. (3) Results: In the template group, a total of 9 pubis screws and 6 sacroiliac screws were inserted. The mean surgical time was 11.3 min/screw and the mean X-ray exposure time was 11.8 ± 3.9 s/screw. The mean deviation distance and angle between the actual and planned screw position was 2.6 ± 0.2 mm and 2.0 ± 0.3 degrees, and blood loss during the surgery was 12.2 ml/screw. No superficial and deep infections and no patient sustained recognized neurologic, vascular, or urologic injury occurred in the template group. The surgical time and X-ray exposure time was less than that in the fluoro-navigation group((P < 0.05) (4) Conclusions: The patient-specific template based on external fixation can guide the insertion of the pelvic screw accurately, safely and invasively and significantly reduce operation and radiation exposure time.

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A Novel Patient-Specific Three-Dimensional Printing Template Based on External Fixation for Pelvic Screw Insertion

10.21203/rs.3.rs-38848/v1 ◽

2020 ◽

Author(s):

Kaihua Zhou ◽

Xingguang Tao ◽

Fugen Pan ◽

Congfeng Luo ◽

Huilin Yang

Keyword(s):

Radiation Exposure ◽

External Fixation ◽

Exposure Time ◽

Patient Specific ◽

Mean Deviation ◽

Surgical Time ◽

X Ray ◽

Screw Insertion ◽

Navigation Group ◽

The Mean

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Radiation exposure of the staff at the therapeutic and diagnostic nuclear medicine department

Nuklearmedizin ◽

10.3413/nukmed-0163 ◽

2008 ◽

Vol 47 (04) ◽

pp. 175-177 ◽

Cited By ~ 4

Author(s):

J. Dolezal

Keyword(s):

Nuclear Medicine ◽

Radiation Exposure ◽

Effective Dose ◽

Radiation Protection ◽

Annual Effective Dose ◽

Protection Measures ◽

Professional Groups ◽

Personal Dosimetry ◽

The Mean ◽

Administered Activity

SummaryAim: To assess a radiation exposure and the quality of radiation protection concerning a nuclear medicine staff at our department as a six-year retrospective study. Therapeutic radionuclides such as 131I, 153Sm, 186Re, 32P, 90Y and diagnostic ones as a 99mTc, 201Tl, 67Ga, 111In were used. Material, method: The effective dose was evaluated in the period of 2001–2006 for nuclear medicine physicians (n = 5), technologists (n = 9) and radiopharmacists (n = 2). A personnel film dosimeter and thermoluminescent ring dosimeter for measuring (1-month periods) the personal dose equivalent Hp(10) and Hp(0,07) were used by nuclear medicine workers. The wearing of dosimeters was obligatory within the framework of a nationwide service for personal dosimetry. The total administered activity of all radionuclides during these six years at our department was 17,779 GBq (99mTc 14 708 GBq, 131I 2490 GBq, others 581 GBq). The administered activity of 99mTc was similar, but the administered activity of 131I in 2006 increased by 200%, as compared with the year 2001. Results: The mean and one standard deviation (SD) of the personal annual effective dose (mSv) for nuclear medicine physicians was 1.9 ± 0.6, 1.8 ± 0.8, 1.2 ± 0.8, 1.4 ± 0.8, 1.3 ± 0.6, 0.8 ± 0.4 and for nuclear medicine technologists was 1.9 ± 0.8, 1.7 ± 1.4, 1.0 ± 1.0, 1.1 ± 1.2, 0.9 ± 0.4 and 0.7 ± 0.2 in 2001, 2002, 2003, 2004, 2005 and 2006, respectively. The mean (n = 2, estimate of SD makes little sense) of the personal annual effective dose (mSv) for radiopharmacists was 3.2, 1.8, 0.6, 1.3, 0.6 and 0.3. Although the administered activity of 131I increased, the mean personal effective dose per year decreased during the six years. Conclusion: In all three professional groups of nuclear medicine workers a decreasing radiation exposure was found, although the administered activity of 131I increased during this six-year period. Our observations suggest successful radiation protection measures at our department.

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The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽

10.1177/1460408620949725 ◽

2021 ◽

pp. 146040862094972

Author(s):

Ahmed Fadulelmola ◽

Rob Gregory ◽

Gavin Gordon ◽

Fiona Smith ◽

Andrew Jennings

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Hospital Admissions ◽

The Elderly ◽

Primary Outcome Measure ◽

Time To Death ◽

Significant Difference ◽

The Mean ◽

The Impact ◽

Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

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Repeated Pelvic Radiographs in Infants, After Harness Treatment for Developmental Dysplasia of the Hip, Carry Very Low Radiation Risk

Indian Journal of Orthopaedics ◽

10.1007/s43465-021-00438-x ◽

2021 ◽

Author(s):

Elizabeth Vogel ◽

Thomas Leaver ◽

Fiona Wall ◽

Ben Johnson ◽

Michael Uglow ◽

...

Keyword(s):

Radiation Exposure ◽

Radiation Risk ◽

Low Risk ◽

Lifetime Risk ◽

Body Region ◽

Pavlik Harness ◽

Pelvic Radiographs ◽

Risk Of Malignancy ◽

The Mean

Abstract Objective There are no data on the effect of X-Ray irradiation to the vulnerable pelvic organs of babies during DDH follow-up. This study aims to calculate, for the first time, the radiation exposure to infants during follow-up for DDH harness treatment, and thus quantify the lifetime risk of malignancy. Methods Patients who had completed 5 years’ follow-up following successful Pavlik harness treatment were identified from the hospital DDH database. The radiation dose was extracted from the Computerised Radiology Information System database for every radiograph of every patient. The effective dose (ED) was calculated using conversion coefficients for age, sex and body region irradiated. Cumulative ED was compared to Health Protection Agency standards to calculate lifetime risk of malignancy from the radiographs. Results All radiographs of 40 infants, successfully treated in Pavlik harness for DDH, were assessed. The mean number of AP pelvis radiographs was 7.00 (range: 6–9, mode: 7). The mean cumulative ED was 0.25 mSv (Range: 0.11–0.46, SD: 0.07). This is far lower than the annual ‘safe’ limit for healthcare workers of 20 mSv and is categorised as “Very Low Risk”. Conclusion Clinicians involved in the treatment DDH can be re-assured that the cumulative radiation exposure from pelvic radiographs following Pavlik harness treatment is “Very Low Risk”. Whilst being mindful of any radiation exposure in children, this study provides a scientific answer that help addresses parental concerns.

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A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0041-1728760 ◽

2021 ◽

Author(s):

Andrew G. Yun ◽

Marilena Qutami ◽

Kory B. Dylan Pasko

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Radiation Exposure ◽

Hip Arthroplasty ◽

Fluoroscopy Time ◽

Lesser Trochanter ◽

Total Hip ◽

Preoperative Templating ◽

The Mean ◽

Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

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Design and biomechanical study of slide-poking external fixator for hip fracture

Journal of International Medical Research ◽

10.1177/0300060520950934 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052095093

Author(s):

Hua-Biao Chen ◽

Hong-Bo Wu ◽

Min Chen ◽

Yu-Liang Huang

Keyword(s):

Hip Fracture ◽

Femoral Head ◽

Hip Fractures ◽

External Fixator ◽

Dynamic Hip Screw ◽

Control Groups ◽

Vertical Loading ◽

Hip Screw ◽

The Mean ◽

And Control

Background Femoral head collapse and coxa vara lead to internal fixator failure in elderly patients with hip fracture. External fixator application is an optimal choice; however, the existing methods have many disadvantages. Methods Type 31-A1.3 hip fracture models were developed in nine pairs of 1-year-old fresh bovine corpse femur specimens. Each left femur specimen was fixed by a dynamic hip screw (control group), and each right femur specimen was fixed by the slide-poking external fixator (experimental group). Vertical loading and torsion tests were then performed in both groups. Results In the vertical loading experiment, a 1000-N load was implemented. The mean vertical downward displacement of the femoral head in the experimental and control groups was 1.49322 ± 0.116280 and 2.13656 ± 0.166374 mm, respectively. In the torsion experiment, when the torsion was increased to 10.0 Nm, the mean torsion angle in the experimental and control groups was 7.9733° ± 1.65704° and 15.4889° ± 0.73228°, respectively. The slide-poking external fixator was significantly more resistant to compression and rotation than the dynamic hip screw. Conclusion The slide-poking external fixator for hip fractures that was designed and developed in this study can provide sufficient stability to resist compression and rotation in hip fractures.

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