Radiation exposure to the hands and the thyroid of the surgeon during intramedullary nailing

Müller, Lars Peter; Suffner, J.; Wenda, K.; Mohr, W.; Rommens, Pol Maria

doi:10.1016/s0020-1383(98)00088-6

Cited by 140 publications

(77 citation statements)

References 8 publications

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“…Ionizing radiation has no safe threshold of exposure below which it ceases to have adverse effects [9,14]. Moreover, long-term effects of this radiation exposure are unknown [7].…”

Section: Discussionmentioning

confidence: 99%

Nail over nail technique for distal locking of femoral intramedullary nails

Rohilla

Singh

Magu

et al. 2008

International Orthopaedics (SICOT)

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The free hand technique remains the most popular method for distal locking; however, radiation exposure is a major concern. In an endeavour to overcome this concern, distal locking with the nail over nail technique is evaluated. Seventy patients with femoral diaphyseal fractures treated by intramedullary nailing were divided in two groups for distal locking: either using the free hand technique (group I) or with the nail over nail technique (group II). The average number of images taken to achieve nail insertion without locking, for distal locking, and for the complete procedure in group I was 25.8, 24.2, and 50.08, respectively, compared with 24.8, 4.1, and 28.9, respectively, in group II (statistically extremely significant decrease in radiation). The nail over nail technique appears to be a reliable solution for decreasing radiation exposure during closed femoral intramedullary nailing. However, over-reaming of 1.5 mm is the key to the success of the technique.

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“…Ionizing radiation has no safe threshold of exposure below which it ceases to have adverse effects [9,14]. Moreover, long-term effects of this radiation exposure are unknown [7].…”

Section: Discussionmentioning

confidence: 99%

Nail over nail technique for distal locking of femoral intramedullary nails

Rohilla

Singh

Magu

et al. 2008

International Orthopaedics (SICOT)

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“…One can operate the C-arm fluoroscopy either in continuous or pulsed modes. Using the pulsed mode rather than the continuous whenever possible can reduce radiation doses 6,8,11) . The forth, exposure to the radiation scattered from patients and surroundings can add to direct radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopic Radiation Exposure during Percutaneous Kyphoplasty

Choi

2011

J Korean Neurosurg Soc

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“…In an average case of intramedullary nailing of lower limbs, 1.27 mSv of radiation has been measured in the hands of surgeons mostly during distal locking, which alone can take up to 51% of the total fluoroscopic time. [12][13][14] The importance of an experienced x-ray technician in the operating room cannot be overemphasized, because the quality of the images and the frequent changes in C-arm position around the patient translate directly into radiation exposure time. 3 The same is true regarding the surgeon's experience; as the trainee progresses through the learning curve to master this surgical technique, his or her radiation exposure decreases.…”

Section: Limitations Of the Current Proceduresmentioning

confidence: 99%

“…26 However, a great number of fluoroscopic images are required in each step of the procedure to achieve successful anatomic reduction and stable fixation, resulting in cumulative radiation exposure to the surgeon, the surgical team, and the patient. 14 Limitations from this technique arise because the images from the C-arm are uncorrelated two-dimensional views with a limited field-of-vision. The surgeon has to mentally correlate in time and space the surgical tools and fracture fragments, manipulate them without direct visual feedback, and obtain a new set of images to confirm the new position.…”

mentioning

confidence: 99%

Computer-Assisted Image-Guided Intramedullary Nailing of Femoral Shaft Fractures

Hazan¹,

Joskowicz²

2003

Techniques in Orthopaedics

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Summary: Closed reduction and intramedullary nailing under x-ray fluoroscopy is the current treatment of choice for femoral shaft fractures. However, many images are required to successfully perform the procedure, especially for distal locking of the nail, resulting in cumulative radiation exposure to the surgeon. Recently, computer-based technologies have been developed for surgical navigation, enabling the surgeon to accurately track in real-time the instruments, implants, and patient anatomy during a procedure. This article reviews the principles and potential benefits of computer-aided image-guided surgery for femoral shaft fracture, its indications, and its pitfalls. The existing systems, commercially available and prototypes, and the early clinical experience using this technique are also briefly discussed.

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Radiation exposure to the hands and the thyroid of the surgeon during intramedullary nailing

Cited by 140 publications

References 8 publications

Nail over nail technique for distal locking of femoral intramedullary nails

Nail over nail technique for distal locking of femoral intramedullary nails

Fluoroscopic Radiation Exposure during Percutaneous Kyphoplasty

Computer-Assisted Image-Guided Intramedullary Nailing of Femoral Shaft Fractures

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