Title : A comparison of the radiation exposure and total exposure time between Conventional C-Arm and Mini C-Arm in wrist and ankle fractures
Abstract:
Objectives: Orthopaedic surgeons have an increased risk of developing cancer due to occupational radiation exposure. When fluoroscopy is required, there is a choice between the Conventional and Mini C-Arm machine. The aim of this study is to investigate whether there is a significant difference between radiation or total exposure time, when using the Mini C-Arm versus the Conventional C-Arm.
Methods: A retrospective cohort study design was used. The data for radiation exposure, total exposure time, number of images taken and fracture classification was collected for 119 ankle and wrist surgeries. The data sets were checked for normality using the Shapiro-Wilk test and through a Q-Q plot. A two tailed Mann-Whitney U test was then used to compare the data between the conventional and mini c-arm.
Results: The mean Dose Area Product (DAP) in ankle surgery was 11.07 cGy·cm2 in cases requiring the conventional c-arm and 6.4 cGy·cm2 for the mini c-arm. This was a statistically significant reduction in DAP (p=0.0164). The mean DAP values for wrist surgery were slightly reduced but showed no significant difference. The mean Total Exposure Time (TET) between was higher in both wrist and ankle surgeries when using the mini c-arm. The difference was significant in wrist surgery (p=0.00062).
Conclusion: The mini c-arm was associated with a significant reduction in ankle ORIF and a mean reduction in wrist ORIF. TET for both ankle and wrist were higher when using the mini c-arm. Implemented recommendations in our centre included further training and distribution of information sheets to remind operators to abide by as low as reasonably achievable principles. Larger and prospective cohort studies are essential to provide definitive guidelines on reduction of radiation exposure.
