Radiation Exposure to the Orthopaedic Surgeon during Fracture Surgery

Ji Wan Kim; Jung Jae Kim

doi:10.4055/jkoa.2010.45.2.107

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Kim and Kim: Radiation Exposure to the Orthopaedic Surgeon during Fracture Surgery

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(2): 107-113.

Published online: 19 April 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.2.107

Radiation Exposure to the Orthopaedic Surgeon during Fracture Surgery

Ji Wan Kim, M.D.^*, Jung Jae Kim, M.D.

Department of Orthopedic Surgery, Asan Medical Center, Uiversity of Ulsan College of Medicine, Seoul, Korea.

^*Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Correspondence to: Jung Jae Kim, M.D. Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, #388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea. TEL: +82-2-3010-3538, FAX: +82-2-488-7877, jjkim2@amc.seoul.kr

Received 2 September 2009 Accepted 16 December 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To assess the risk of radiation exposure by measuring the equivalent dose during fracture surgery.

Materials and Methods

Two orthopedic trauma surgeons were enrolled in this study from April to June 2009. The equivalent dose was measured using thermoluminiscent dosimeters placed at the left (in and out of the lead apron).

Results

The equivalent dose measured from the apron over the 3 month period were 5.22 mSv, 4.34 mSv(outside), and 1.83 mSv and 0.71 mSv(inside). The rate of radiation reduction was 64.9% and 83.6% respectively.

Conclusion

The estimated annual equivalent dose outside the apron was close to or higher than the maximum limit of radiation exposure. These findings highlight the need for surgeons to be more cautious about radiation exposure during fracture management and take active steps to minimize radiation exposure, such as wearing a radio-protective apron.

Keywords: fracture surgery, fluoroscopy, radiation exposure, equivalent dose

Figures and Tables

Figure 1

Photograph showing the location of TLD (thermo luminescent dosimeter). One TLD is placed at the left chest (in and out of the apron). The radio-protective apron is a half apron.

Figure 2

C-arm fluoroscopy with x-ray tube and image intensifier. (A) Typical C-arm fluoroscopy. (B) Inverted C-arm fluoroscopy.

Figure 3

Stray radiation fields for lateral projection. (A) 100 cm and (B) 150 cm above the floor (Reprinted, with permission, from reference 25).

Table 1

Annual Recommended Limits for Occupational and Nonoccupational Radiation Exposure

^*The international Commission on Radiological Protection recommends a maximum of 20 mSv/yr; the National Council on Radiation Protection and Measurements recommends a maximum of 50 mSv/yr.

Table 2

The Equivalent Dose (mSv) Exposure Measured with TLD

TLD, thermo-luminescent dosimeter.

Table 3

Estimates of Exposure Time during Surgical Procedure

MIPO, minimal invasive plate osteosynthesis; ORIF, open reduction and internal fixation; m, minute; s, second.

Table 4

Distribution of Annual Radiation Exposure of Korean Doctors in 2007

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