title: Radiation exposure of the hands and thyroid gland during percutaneous wiring of wrist and hand procedures.
abstract: The aim of this study was to investigate the radiation exposure of the hands and thyroid glands of orthopaedic surgeon and assistant during procedures involving percutaneous wiring of the hand and wrist. The radiation dose to the hand and thyroid glands was prospectively studied from a total of 30 percutaneous hand and wrist procedures. Four thermolucent densitometers were used to measure the radiation exposure. Cases were divided depending on fracture location (ie. wrist, metacarpal, phalangeal) and surgical experience (i.e. Senior House Officer, Registrar, Consultant). Mean radiation exposure in the hand for the surgeon was 0.80 mSv and 0.87 mSv for the assistant. There was a significant difference in the unshielded thyroid group compared to the shielded thyroid group (p < 0.05). The duration and number of exposure decreases with increasing experience. We also found a trend whereas we operate from proximal to distal (wrist to phalangeal), the total direct hand exposure increases. Radiation exposure in the hands and thyroid glands during percutaneous wiring of hand and wrist procedures were within the recommended limit. However, for the junior orthopaedic trainee, the risk of over radiating oneself is higher as the duration and number of exposure increases. We recommended the use of thyroid shield and adherence to the ALARA principle in any fluoroscopic assisted procedures. Routine monitoring of radiation exposure is essential in preventing radiation related disease.
authors.affiliation: Department of Trauma and Reconstructive Surgery, Adelaide and Meath Hospital incorporating National Children Hospital, Tallaght, Dublin, Ireland. syahbahari@gmail.com
authors.forename: Syah
authors.initials: S
authors.lastname: Bahari
authors.forename: Seamus
authors.initials: S
authors.lastname: Morris
authors.forename: David
authors.initials: D
authors.lastname: Broe
authors.forename: Colm
authors.initials: C
authors.lastname: Taylor
authors.forename: Brian
authors.initials: B
authors.lastname: Lenehan
authors.forename: John
authors.initials: J
authors.lastname: McElwain
mesh_terms: D005471:Fluoroscopy / Q000009:adverse effects*; D005594:Fracture Fixation, Intramedullary; D006225:Hand / Q000528:radiation effects* / Q000601:surgery*; D006801:Humans; D009985:Orthopedics; D011446:Prospective Studies; D011829:Radiation Dosage; D013819:Thermoluminescent Dosimetry; D013961:Thyroid Gland / Q000528:radiation effects*; D013997:Time Factors; D014955:Wrist Joint / Q000601:surgery*