The risks following the exposure to radiation associated with the surgical correction of limb deformities in children are minimal

Abstract

Aims The aim of this study was to quantify the risk of developing cancer from the exposure to radiation associated with surgery to correct limb deformities in children. Patients and Methods A total of 35 children were studied. There were 19 girls and 16 boys. Their mean age was 11.9 years (2 to 18) at the time of surgery. Details of the radiological examinations were recorded during gradual correction using a Taylor Spatial Frame. The dose area product for each radiograph was obtained from the Computerised Radiology Information System database. The effective dose in millisieverts (mSv) was calculated using conversion coefficients for the anatomical area. The lifetime risk of developing cancer was calculated using government-approved Health Protection Agency reports, accounting for the age and gender of the child. Results Correction was undertaken in five femurs, 18 tibiae, and 12 feet. The median duration of treatment was 45 months (11 to 118). The mean effective dose was 0.31 mSv (0.05 to 0.64) for the femur, 0.29 mSv (0.01 to 0.97) for the tibia, and 0.027 mSv (0.001 to 0.161) for the foot. The cumulative exposure gave ‘negligible’ risk in 26 children and ‘minimal’ risk in nine children, according to Public Health England categories. These results are below the mean annual background radiation in the United Kingdom. Conclusion The lifetime attributable risk of developing cancer from repeated exposure to radiation was negligible or minimal in all children. This is the first study to quantify the exposure to radiation from serial radiographs in children with limb deformities who are treated surgically using circular external fixation, linking this to the risk of developing cancer. Cite this article: Bone Joint J 2019;101-B:241–245.

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

“…This study was limited to forty patients, in keeping with a similar study on radiation exposure in paediatric limb deformity [ 33 ]. Whilst there were some variations in the ED between the patients in this study, this patient group was more homogenous than the limb deformity group, and the range of cumulative ED was minimal.…”

Isolated Medial Cuneiform Fractures: A Systematic Search and Qualitative Analysis of Case Studies

“…57,58 However, given the low radiation exposure, expedience, and costeffectiveness of plain film radiographs, these may still offer value as a primary imaging modality. 59,60 Lisfranc injury would be a typical differential diagnosis of isolated medial cuneiform fractures before imaging results. Given the ability for weightbearing foot radiographs to aid in ligamentous disruption via expansion of joint spaces, we suggest weightbearing foot radiographs as tolerated to aid in this differential diagnosis.…”

Environmental Risk Factors for Childhood Cancer in an Era of Global Climate Change: A Scoping Review

“…In California, Bartley, Metayer, Selvin, Ducore, and Buffler (2010) conducted a case-control study of children with ALL or AML and self-reported x-rays after birth and found the exposure between exposure to three or more diagnostic x-rays is associated with increased risk of childhood ALL but not AML. Researchers in the United Kingdom quantified the risk of developing cancer from the exposure to radiation associated with surgery to correct limb deformities in children and found the lifetime attributable risk of developing cancer from repeated exposure to radiation was negligible or minimal in all children (Leaver, Johnson, Lampard, Aarvold, & Uglow, 2019). In another study conducted in the United Kingdom by Harbron et al (2018) investigated cancer incidence among a cohort of 11,270 individuals who underwent cardiac catheterizations from hospital records and found that cancer rates among children and young adults who undergo x-ray guided catheterizations are higher than the general population; however, researchers found that heart transplantation appears to be a large contributor to elevated cancer rates in this patient group.…”