Radiation exposure to the surgeon during closed interlocking intramedullary nailing.

TLDR

The study recommends precautions to be observed during closed interlocking intramedullary nailing. Radiation exposure was quantified by having the surgeon wear a film badge on the lead apron collar and thermoluminescent dosimeter rings on the dominant hand, with separate recordings for distal interlocking, and the doses were averaged across 30 femoral and tibial fracture procedures. Average radiation doses were 7.0 mrem deep and 8.0 mrem shallow to the head and neck, and 13.0 mrem to the dominant hand during nail and proximal interlocking insertion and 12.0 mrem during distal interlocking, all well below government limits for a quarter‑year exposure.

Abstract

During interlocking intramedullary nailing of twenty-five femoral and five tibial fractures, the primary surgeon wore both a universal film badge on the collar of the lead apron and a thermoluminescent dosimeter ring on the dominant hand to quantify the radiation that he or she received. When distal interlocking was performed, the first ring was removed and a second ring was used so that a separate recording could be made for this portion of the procedure. At the conclusion of the study, all of the recorded doses of radiation were averaged. The average amount of radiation to the head and neck during the entire procedure was 7.0 millirems of deep exposure and 8.0 millirems of shallow exposure. The average dose of radiation to the dominant hand during insertion of the intramedullary nail and the proximal interlocking screw was 13.0 millirems, while the average amount during insertion of the distal interlocking nail was 12.0 millirems. Both of these averages are well within the government guidelines for allowable exposure to radiation during one-quarter (three months) of a year. Precautions that are to be observed during this procedure are recommended.