Radiation Doses to Patients Undergoing Osteosynthesis Procedures

Abstract

Fractures of limbs are most frequent causes of orthopaedic interventions. Especially the older people are exposed to these because of motion disorders and osteoporosis. Most of orthopaedic surgery interventions are performed under X-rays control to achieve an optimal settings the anatomical details and also some artificial implants, if such are necessary. Because if that, X-ray units are common equipment in operational theatre where orthopaedic procedures are performed. As a rule they are mobile C-arm units, which are easy available in any time when are necessary. A consequence of every usage of X-rays an exposure to patient but also to operational medical team [1-3]. They are a number of factors affecting both the patient and staff irradiation. There are three categories: patient dependent, equipment dependent and procedure dependent factors. Patient dependent factors include: body thickness in the beam, complexity of the anatomic structure. Equipment dependent factors include: setting of dose rates in pulsed fluoro- and continuous fluoro mode, last image hold, acquisition, and virtual collimation. The main procedure related factors are: number of radiographic frames per run, collimation, fluoroscopic and radiographic acquisition modes, fluoroscopy time, wedge filter, magnification, distance of patient to image receptor (image intensifier or flat panel detector), distance between X-ray tube and patient, and tube angulations. Very important is also the experience of the operator. In case of patient, this is especially important for the procedures when the primary beam can cover the part of the trunk. Such situation has place in the procedure of osteosynthesis the femoral bone, reconstruction of head of femur and also osteosynthesis the humeral bone. Despite a relatively short time of real exposures, doses to patients undergoing these procedures can achieve quite high values: the entrance skin air kerma (here named the “dose”) over 80 mGy was also recorded. Additionally, in practice the primary X-ray beam incident on the same area patient’ body making a higher risk of radiation detriments. The paper presents collection of doses recorded for patients undergoing the procedures of osteosynthesis the femoral bone and the humeral bone during last moths in the big university clinic.