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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 4/2020

01-04-2020 | Orthopaedic Surgery

Radiation exposure in the treatment of pediatric supracondylar humerus fractures

Authors: Alex Schmucker, Roy Chen, Shobhan Vachhrajani, Melissa Martinek, Michael Albert

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2020

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Abstract

Purpose

To determine the factors that influence radiation exposure during repair of supracondylar humerus fractures.

Methods

Medical records of almost 200 children with supracondylar fractures were retrospectively analyzed for variables correlated with fluoroscopy time and radiation dose as measures of radiation exposure.

Results

There was no statistically significant difference in fluoroscopy time (27 vs. 22 s p = 0.345) or direct radiation dose (0.394 vs. 0.318 mSv p = 0.290) between uniplanar and biplanar C-arm use. No statistically significant differences in fluoroscopy time or radiation dose were found for surgical technique, comorbid ipsilateral fractures, preoperative neurovascular compromise, or resident participation. There was a significant 8.3 s increase in fluoroscopy time (p = 0.022) and 0.249 mSv increase in radiation dose (p = 0.020) as the fracture type increased from II to III. An increase in one pin during CRPP resulted in a statistically significant 10.4 s increase in fluoroscopy time and a 0.205 mSv increase in radiation dose. There were significant differences between the physician with the lowest fluoroscopy time and radiation dose compared with the physicians with the two highest values for both fluoroscopy time and radiation dose (p < 0.01).

Conclusions

We found no significant difference in direct radiation exposure or fluoroscopy time when comparing biplanar to uniplanar C-arm use, resident participation, preoperative neurovascular compromise, or for comorbid ipsilateral fractures. Both outcomes increased significantly as fracture type increased from II to III and as the number of pins used during CRPP increased. Both outcomes were significantly different between the surgeons performing CRPP.
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Metadata
Title
Radiation exposure in the treatment of pediatric supracondylar humerus fractures
Authors
Alex Schmucker
Roy Chen
Shobhan Vachhrajani
Melissa Martinek
Michael Albert
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 4/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-019-03251-2

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