Use of the mini C-arm for wrist fractures--establishing a diagnostic reference level

Love, Gavin J.; Pillai, Anand; Gibson, Suzy

doi:10.1093/rpd/ncm376

Cited by 12 publications

(6 citation statements)

References 2 publications

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“…(125) Over the past several decades, mini C-arm fluoroscopy has emerged as a convenient imaging tool that has the potential to reduce radiation dose. Exposure levels have been studied during various orthopaedic procedures and scenarios (Athwal et al, 2005;Giordano et al, 2007Giordano et al, , 2009bLarson et al, 2008;Love et al, 2008). Some operators may believe that provided they are outside the primary beam and they do not see their body part in the image, their exposure is negligible.…”

Section: Radiation Dose Managementmentioning

confidence: 99%

Radiological Protection in Fluoroscopically Guided Procedures Performed Outside the Imaging Department

Rehani¹,

Ciraj-Bjelac²,

Vañó³

et al. 2010

Ann ICRP

227

137

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An increasing number of medical specialists are using fluoroscopy outside imaging departments, but there has been general neglect of radiological protection coverage of fluoroscopy machines used outside imaging departments. Lack of radiological protection training of those working with fluoroscopy outside imaging departments can increase the radiation risk to workers and patients. Procedures such as endovascular aneurysm repair, renal angioplasty, iliac angioplasty, ureteric stent placement, therapeutic endoscopic retrograde cholangio-pancreatography,and bile duct stenting and drainage have the potential to impart skin doses exceeding Gy. Although tissue reactions among patients and workers from fluoroscopy procedures have, to date, only been reported in interventional radiology and cardiology,the level of fluoroscopy use outside imaging departments creates potential for such injuries.A brief account of the health effects of ionising radiation and protection principles is presented in Section 2. Section 3 deals with general aspects of the protection of workers and patients that are common to all, whereas specific aspects are covered in Section 4 for vascular surgery, urology, orthopaedic surgery, obstetrics and gynaecology,gastroenterology and hepatobiliary system, and anaesthetics and pain management.Although sentinel lymph node biopsy involves the use of radio-isotopic methods rather than fluoroscopy, performance of this procedure in operating theatres is covered in this report as it is unlikely that this topic will be addressed in another ICRP publication in coming years. Information on radiation dose levels to patients and workers, and dose management is presented for each speciality.

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Section: Radiation Dose Managementmentioning

confidence: 99%

Radiological Protection in Fluoroscopically Guided Procedures Performed Outside the Imaging Department

Rehani¹,

Ciraj-Bjelac²,

Vañó³

et al. 2010

Ann ICRP

227

137

View full text Add to dashboard Cite

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“…Previous studies have investigated the use of intraoperative radiography with the aim of establishing local diagnostic reference levels. 11,12 The current authors suggest that their data be used to set acceptable levels of radiation for Weber B ankle fixation procedures. Excessive use of intraoperative flu-oroscopy may be used as a marker of lack of confidence and trainer supervision.…”

Section: Discussionmentioning

confidence: 96%

Intraoperative Radiation Use by Trainees During Ankle Fracture Fixation

Kheiran¹,

Makki²,

Banerjee³

et al. 2013

Orthopedics

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Orthopedic trainees are assessed during training regarding their use of radiological screening during operative procedures. The authors investigated whether orthopedic trainees' use of fluoroscopic screening during ankle fixation operations varied with the 2 variables of consultant supervision and trainee experience. Data from operative fixation of isolated Weber B ankle fractures were reviewed. The intraoperative radiation dose was retrieved from radiographers' data. Operations performed by consultants were used as a control group (n=25 patients). Trainee supervision was assessed as "trainer in operating room (OR)" and "trainer out of OR." Regarding experience, the patients were divided into those operated on primarily by trainees in their first (n=36 patients) and in their last (n=34 patients) 3 years of formal specialist training. All trainee groups used more radiation than consultants. Supervision did not affect the radiation use of senior trainees (P<.05). Senior trainees used less radiation than their junior peers (P<.02). Junior trainees supervised by a trainer in the OR used less radiation than junior trainees supervised by a trainer outside of the OR (P<.05). During open reduction and internal fixation of ankle fractures, junior orthopedic trainees use less intraoperative radiation when they are supervised by a trainer in the OR. The more experience a surgeon has, the less fluoroscopic screening is used during operative ankle fixation.

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“…Intraoperative 3D computed tomography (CT) techniques can provide information regarding soft tissue morphology and structure. This technique is particularly suitable for differentiating between bones and other tissues and, thus, has been often used in image-guided surgery such as oral surgery [17], orthopaedic surgery [18], neurosurgery [19] as well as prostate brachytherapy [20]. However, owing to the cost and the radiation exposure associated with this technique, it is not ideal to be used to measure tissue deformation intraoperatively during MIS.…”

Section: The Measurement Of Rolling Indentation Depthmentioning

confidence: 99%

An indentation depth—force sensing wheeled probe for abnormality identification during minimally invasive surgery

Liu

Puangmali

Zbyszewski

et al. 2010

Proc Inst Mech Eng H

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This paper presents a novel wheeled probe for the purpose of aiding a surgeon in soft tissue abnormality identification during minimally invasive surgery (MIS), compensating the loss of haptic feedback commonly associated with MIS. Initially, a prototype for validating the concept was developed. The wheeled probe consists of an indentation depth sensor employing an optic fibre sensing scheme and a force/torque sensor. The two sensors work in unison, allowing the wheeled probe to measure the tool-tissue interaction force and the rolling indentation depth concurrently. The indentation depth sensor was developed and initially tested on a homogenous silicone phantom representing a good model for a soft tissue organ; the results show that the sensor can accurately measure the indentation depths occurring while performing rolling indentation, and has good repeatability. To validate the ability of the wheeled probe to identify abnormalities located in the tissue, the device was tested on a silicone phantom containing embedded hard nodules. The experimental data demonstrate that recording the tissue reaction force as well as rolling indentation depth signals during rolling indentation, the wheeled probe can rapidly identify the distribution of tissue stiffness and cause the embedded hard nodules to be accurately located.

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Use of the mini C-arm for wrist fractures--establishing a diagnostic reference level

Cited by 12 publications

References 2 publications

Radiological Protection in Fluoroscopically Guided Procedures Performed Outside the Imaging Department

Radiological Protection in Fluoroscopically Guided Procedures Performed Outside the Imaging Department

Intraoperative Radiation Use by Trainees During Ankle Fracture Fixation

An indentation depth—force sensing wheeled probe for abnormality identification during minimally invasive surgery

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