Do we glow? Evaluation of trauma team work habits and radiation exposure

Hassan, Maleeha; Patil, Abhijit; Channel, Jane; Khan, Fawad; Knight, Jennifer; Loos, Matthew S.; Hazard, Hannah; Schaefer, Gregory; Wilson, Alison

doi:10.1097/ta.0b013e318265c9fa

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…3 The remaining proportion (15%) of the annual ionizing radiation dose comes from artificial sources, which for some persons consists of medical ionizing radiation. Most human exposure to ionizing radiation comes from natural sources in the environment.…”

mentioning

confidence: 99%

Applications of Musculoskeletal Ultrasonography in Pediatric Patients

Vanderhave

Brighton

Casey

et al. 2014

Journal of the American Academy of Orthopaedic Surgeons

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Ultrasonography is an excellent adjunct to other musculoskeletal imaging tools utilized in the pediatric population and in some instances offers advantages over CT and MRI. It permits dynamic examination of anatomic structures and assists in guiding minimally invasive procedures. In the lower extremity, ultrasonography assists in screening for such disorders as developmental dysplasia of the hip and in detecting slipped capital femoral epiphysis and femoral acetabular impingement. In the neonatal spine, ultrasonography can identify unossified vertebral arches. Among other applications in the upper extremity, ultrasonography may be used in the evaluation and examination of peripheral nerve injuries and is a preferred modality for imaging the shoulder in infants with neonatal brachial plexus palsy. It is also considered an optimal adjunct for administration of botulinum toxin-A in children with cerebral palsy. The portability, relative low cost, lack of radiation, and absence of known contraindications enhances the utility of ultrasonography in pediatric orthopaedics.

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mentioning

confidence: 99%

Applications of Musculoskeletal Ultrasonography in Pediatric Patients

Vanderhave

Brighton

Casey

et al. 2014

Journal of the American Academy of Orthopaedic Surgeons

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“…Risks of radiation exposure are well published, and experience level with imaging techniques and level of training play a role. [24][25][26][27] Orthopaedic traumatologists must be especially vigilant because they use fluoroscopy with significant frequency. 28 It may be difficult to compare final intraoperative images with plain radiographs obtained at subsequent postoperative clinic visits.…”

Section: Discussionmentioning

confidence: 99%

Transparency films: intraoperative templating to prevent limb deformity

Stine,

Joiner,

Andersen

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Operative management of fractures and malunions can be challenging when restoring native anatomy is not straightforward. Comminuted fractures and managing deformity correction in the setting of osteolysis, callus, and even complete fracture healing must include careful planning. Preoperative planning has been popularized and taught as an integral part of a surgeon's skill set, with critical evaluation and assessment of the implemented plan being the final step in the process. We present a robust, reproducible, and cost-effective technique for intraoperative fracture fixation assessment with case examples, used routinely at our institution.

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“…The rates of use of fluoroscopy and protective devices in our study were comparable with those in a worldwide study on orthopedic surgeons that reported that more than half of the procedures performed by 61.5% of the surgeons involved radiation exposure, whereas the rates of using lead aprons, thyroid shields, and lead glasses were 65, 30.8, and 2.5%, respectively [ 16 ]. According to a US survey, 50% of the subjects reported that lead aprons were not available and the remaining half reported that they were not appropriately sized [ 20 ]. The other study reported that one out of three orthopedic surgery residents were not provided protective gowns in the U.S. [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Irish orthopedic surgeons also reported that the regular use of dosimeters among the orthopedic trainees was 15% [24], and only 5% of the orthopedic surgeons were reported to wear the TLD during surgery in Turkey [10]. A possible reason for the orthopedic surgeons not preferring to wear the dosimeters is that they may believe that it will affect their performance and make them uncomfortable [20,25]. Another reason may be that if their radiation exposure was greater than the specified limit, they would be prohibited from operating with fluoroscopy for a specified period of time; therefore, they do not routinely wear the personal dosimetry badges [26].…”

Section: Personal Protective Equipment Usementioning

confidence: 99%

Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea

Kang

Shil

Bang

et al. 2020

J Occup Med Toxicol

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Background The use of fluoroscopically-guided interventional (FGI) procedures by orthopedic surgeons has been increasing. This study aimed to investigate the occupational radiation exposure among orthopedic surgeons in South Korea. Methods A nationwide survey of orthopedic surgeons was conducted in South Korea in October 2017. The dosimetry data of the participants were obtained from the National Dosimetry Registry. The orthopedic surgeons were categorized by job specialty [spine or trauma specialists, other orthopedic specialists, and residents], and descriptive statistics for the demographics and work-related characteristics were presented. Multivariable logistic regression analysis was used to evaluate the risk factors for the orthopedic surgeons who were not linked with the dosimetry data. Results Among the total participants ( n = 513), 40.5% of the orthopedic surgeons spent more than 50% of their time working with the FGI procedures when compared with their overall work. The average frequency of the FGI procedures among the orthopedic surgeons was 12.3 days per month. Less than 30% of the participants were regularly provided with radiation monitoring badges. The proportion of subjects who always wore lead aprons and thyroid shields were 52 and 29%, respectively. The residents group experienced more unfavorable working conditions of radiation exposure than the other specialists. The dosimetry data were not significantly linked among the residents (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.11–3.95) and orthopedic surgeons working at small hospitals (OR 4.76, 95% CI 1.05–21.51). Conclusions Although orthopedic surgeons often performed FGI procedures, they wore protective gear less frequently, and a large proportion of orthopedic surgeons were not monitored by the national radiation dosimetry system. As the number of radiation procedures performed by the orthopedic surgeons increases, more intensive approaches are needed to reduce radiation exposure, especially for spine and trauma surgeons.

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Do we glow? Evaluation of trauma team work habits and radiation exposure

Abstract: Epidemiologic study, level III.

Cited by 10 publications

References 14 publications

Applications of Musculoskeletal Ultrasonography in Pediatric Patients

Applications of Musculoskeletal Ultrasonography in Pediatric Patients

Transparency films: intraoperative templating to prevent limb deformity

Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea

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