Radiation exposure to the hands and the thyroid of the surgeon during intramedullary nailing.
During 41 procedures of intramedullary nailing of femoral and tibial fractures, the primary surgeon and the first assistant wore ring dosimeters on their dominant index fingers.
While the average fluoroscopy time per procedure was 4.6 min, the average dose of radiation to the dominant hand of the primary surgeon was 1.27 mSv and 1.19 mSv to the first assistant.
The dose limit for the extremities is 500 mSv per year, as recommended by the International Commission on Radiological Protection.
Extrapolation of the mean dose of the primary surgeon and first assistent per procedure of 1.23 mSv leads to the result that the recommended dose limit of 500 mSv would only be exceeded if more than 407 intramedullary nailing procedures are carried out per year.
The duration of fluoroscopy time correlated with the radiation dose to the hands of the surgeons, though it was determined by phantom measurements that the majority of radiation exposure occurred during brief exposures of the hands in the direct X-ray beam on the X-ray tube near side of the patient.
In order to assess the surface doses of the thyroid gland to the primary surgeon with and without a lead shield, we performed in vitro measurements during operative procedures of the lower leg simulating different intraoperative situations under fluoroscopic control.
The average registered ionizing dosage without a thyroid shield was approximately 70 times higher than with thyroid lead protection. (...)
Mots-clés Pascal : Enclouage centromédullaire, Radioscopie, Fracture, Tibia, Fémur, Irradiation(personne), Main, Membre supérieur, Thyroïde, Chirurgien, Dose limite, Médecine travail, Dose rayonnement, Traitement, Prévention, Homme, Fantôme, Peropératoire, Chirurgie orthopédique, Système ostéoarticulaire pathologie, Traumatisme, Radiodiagnostic
Mots-clés Pascal anglais : Intramedullary nailing, Radioscopy, Fracture, Tibia, Femur, Radiation exposure(person), Hand, Upper limb, Thyroid gland, Surgeon, Limit dose, Occupational medicine, Radiation dose, Treatment, Prevention, Human, Ghost, Intraoperative, Orthopedic surgery, Diseases of the osteoarticular system, Trauma, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0376866
Code Inist : 002B25I. Création : 25/01/1999.