title: The primary determinants of radiation use during fixation of proximal femur fractures.
abstract: OBJECTIVE
  To establish the primary determinants of operative radiation use during fixation of proximal femur fractures.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Level I trauma centre.
  
  
  METHODS
  205 patients treated surgically for subtrochanteric and intertrochanteric femoral fractures.
  
  
  METHODS
  Fluoroscopy time, dose-area-product (DAP).
  
  
  RESULTS
  Longer fluoroscopy time was correlated with higher body mass index (p=0.04), subtrochanteric fracture (p<0.001), attending surgeon (p=0.001), and implant type (p<0.001). Increased DAP was associated with higher body mass index (p<0.001), subtrochanteric fracture (p=0.002), attending surgeon (p=0.003), lateral body position (p<0.001), and implant type (p=0.05).
  
  
  CONCLUSIONS
  The strongest determinants of radiation use during surgical fixation of intertrochanteric and subtrochanteric femur fractures were location of fracture, patient body position, patient body mass index, and the use of cephalomedullary devices. Surgeon style, presumably as it relates to teaching efforts, seems to strongly influence radiation use.
authors: Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: mbaratz@gmail.com.
authors: Michael D
authors: MD
authors: Baratz
authors: Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: yhu@bidmc.harvard.edu.
authors: Yue-Yung
authors: YY
authors: Hu
authors: Department of Anesthesia, Children's Hospital Boston, Boston, MA, United States. Electronic address: David.Zurakowski@childrens.harvard.edu.
authors: David
authors: D
authors: Zurakowski
authors: Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: pappleto@bidmc.harvard.edu.
authors: Paul
authors: P
authors: Appleton
authors: Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: ekrodrig@bidmc.harvard.edu.
authors: Edward K
authors: EK
authors: Rodriguez
mesh_terms: D000369:Aged, 80 and over; D015992:Body Mass Index; D001863:Bone Screws; D002983:Clinical Competence; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control*; D010348:Patient Care Team; D011482:Protective Devices / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011835:Radiation Protection; D012189:Retrospective Studies; D016683:Supine Position; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome