title: Real-time dosimetry reduces radiation exposure of orthopaedic surgeons.
abstract: BACKGROUND
  Cancer prevalence of orthopaedic surgeons is elevated and chronic exposure to occupational ionizing radiation is seen as one reason.
  
  
  OBJECTIVE
  Use of a new dosimeter enabling radiation dose monitoring in real-time may reduce radiation exposure of orthopaedic surgeons.
  
  
  METHODS
  Over a period of four months, the surgeon and the C-arm operator were equipped with a novel dosimeter called DoseAware(®) (DA) while using the C-arm fluoroscope intraoperatively. Data of 68 patients DA were retrospectively compared using matched-pair analysis with 68 controls without DA. Both groups were assessed regarding fluoroscopic time (FT) and radiation dose (RD). Seven types of operative procedures were performed: internal fixation of subcapital humerus fractures, midshaft clavicular fractures, distal radius fractures, pertrochanteric femoral fractures, ankle fractures, traumatic vertebral fractures and osteoporotic vertebral fractures.
  
  
  RESULTS
  Concerning the FT, use of DoseAware(®) led to a significant reduction for all evaluated operation types except for internal fixation of distal radius fractures (P=0.0511). Regarding the RD, use of DoseAware(®) led to a significant reduction for all evaluated operation types except trochanteric femoral fractures with a PFNA(®) (P=0.0841).
  
  
  CONCLUSIONS
  DoseAware(®) allowing real-time radiation dose monitoring reduces radiation exposure of the orthopaedic surgeon and instantly demonstrates the effects of dose-reduction techniques.
  
  
  METHODS
  Level III retrospective case control study.
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. Electronic address: Marcus.Mueller@ukb.uni-bonn.de.
authors.forename: M C
authors.initials: MC
authors.lastname: Müller
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Welle
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Strauss
authors.affiliation: Department of Radiology, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
authors.forename: P C
authors.initials: PC
authors.lastname: Naehle
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
authors.forename: P H
authors.initials: PH
authors.lastname: Pennekamp
authors.affiliation: Department of Orthopaedics, Trauma and Hand Surgery, St. Martinus Hospital Olpe, Hospitalweg 6, 57462 Olpe, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Weber
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Burger
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D005858:Germany; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control*; D009985:Orthopedics; D011832:Radiation Injuries / Q000517:prevention & control; D011874:Radiometry / Q000295:instrumentation; D012189:Retrospective Studies; D066231:Surgeons
keywords: Dosimetry; Occupational exposure; Orthopaedic surgery; Radiation