Research ArticleOpen Access

Site-Specific Radiation Exposure during Intramedullary Nails: A Comparison between the Free-Hand Technique and the Electromagnetic Assisted Technique

Volume 3 - Issue 3

**Hiroki Kobayashi*¹, Hidenori Tanikawa², Ryo Ogawa³, Kazunari Okuma⁴, Shu Kobayashi³, Kengo Harato³ and Yasuo Niki³**

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- ¹Department of Orthopaedic Surgery, Sanokousei General Hospital, Tochigi, Japan
- ²Department of Orthopaedic Surgery, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
- ³Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- ⁴Department of Orthopaedic Surgery, Saitama City Hospital, Saitama, Japan
*Corresponding author: Hiroki Kobayashi, Department of Orthopaedic Surgery, Sanokousei General Hospital 1728 Horikome-chou, Sano-shi, Tochigiken, Japan, Postal code: 3278511

Received: March 12, 2018; Published: March 28, 2018

DOI: 10.26717/BJSTR.2018.03.000892

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Abstract

Background: We compared the operative time, fluoroscopy time and site-specific radiation exposure during intramedullary nailing for long bone fractures between classical free-hand (FH) technique and electromagnetic (EM) assisted technique.

Methods: Eleven patients with femoral or tibial fractures subjected to intramedullary nailing were studied. The intramedullary nails were performed using FH technique or EM assisted technique with the SURESHOT™ Distal Targeting System. Ten dosimeters were attached on the patient’s and surgeon’s body to measure the site-specific radiation exposure. The variables, including radiation exposure (patient’s eyes, patient’s genitals, fracture site, surgeon’s eyes, surgeon’s genitals, surgeon’s hands), surgical time and fluoroscopy time required for fixation of the distal locking screw, were statistically compared between group FH and group EM using two-tailed Student’s t-tests.

Results: Fluoroscopy time required for fixation of the distal locking screw was significantly shorter on the Group EM (0.57 ± 0.40 minutes) than Group FH (2.36 ± 1.15 minutes), while there was no significant difference in the operative time for the fixation of the distal locking screw between the two groups. Radiation exposure of the fracture site was significantly smaller in the group EM (2.9 ± 1.5 mSv) than the group FH (11.9 ± 5.5 mSv). The radiation exposure of surgeon’s hands was smaller in the group EM (0.15 ± 0.10 mSv) than the group FH (2.00 ± 2.56 mSv), also the radiation exposure of surgeon’s eyes was smaller in the group EM (0.065 ± 0.069 mSv) than the group FH (0.19 ± 0.15 mSv), however no significant difference was observed.

Conclusion: This study suggests that the EM assisted technique is effective for reducing the radiation exposure of patients as well as the orthopaedic surgeons during Intramedullary nailing.

Keywords: Radiation Exposure; Intramedullary Nailing; Fractures; Electromagnetic Assisted Technique

Abbreviations: FT: Free-hand; EM: Electromagnetic; SD: Standard Deviation