title: Ionising radiation exposure in patients with circular frame treatment of distal tibial fractures.
abstract: Total radiation exposure accumulated during circular frame treatment of distal tibial fractures was quantified in 47 patients treated by a single surgeon from February 2007 until Oct 2010. The radiation exposures for all relevant radiology procedures for the distal tibial injury were included to estimate the radiation risk to the patient. The median time of treatment in the frame was 169 days (range 105-368 days). Patients underwent a median of 13 sets of plain radiographs; at least one intra operative exposure and 16 patients underwent CT scanning. The median total effective dose per patient from time of injury to discharge was 0.025mSv (interquartile range 0.013-0.162 and minimum to maximum 0.01-0.53). The only variable shown to be an independent predictor of cumulative radiation dose on multivariate analysis was the use of CT scanning. This was associated with a 13-fold increase in overall exposure. Radiation exposure during treatment of distal tibial fractures with a circular frame in this group was well within accepted safe limits. The fact that use of CT was the only significant predictor of overall exposure serves as a reminder to individually assess the risk and utility of radiological investigations on an individual basis. This is consistent with the UK legal requirements for justification of all X-ray imaging, as set out in the Ionising Radiation (Medical Exposure) Regulations 2000 [1].
authors.affiliation: Department of Orthopaedics and Trauma, Hull Royal Infirmary, Hull, UK. Electronic address: helen.bryant3@nhs.net.
authors.forename: H
authors.initials: H
authors.lastname: Bryant
authors.affiliation: Department of Orthopaedics and Trauma, Hull Royal Infirmary, Hull, UK.
authors.forename: P M C
authors.initials: PM
authors.lastname: Dearden
authors.affiliation: Department of Orthopaedics and Trauma, Leeds General Infirmary, Leeds, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Harwood
authors.affiliation: Radiation Physics Department, Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Hull, UK and Department of Engineering, Faculty of Science, University of Hull, Hull, UK.
authors.forename: T J
authors.initials: TJ
authors.lastname: Wood
authors.affiliation: Department of Orthopaedics and Trauma, Hull Royal Infirmary, Hull, UK.
authors.forename: H K
authors.initials: HK
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019983:Guideline Adherence / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000331:legislation & jurisprudence*; D011839:Radiation, Ionizing; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods*; D006113:United Kingdom / Q000453:epidemiology
keywords: Carcinogenic; Circular frame; Computerised tomography; Distal; Fracture; Radiation; Tibia