Title : The impact of draping technique on radiation exposure during Dynamic Hip Screw (DHS) fixation for hip fractures
Abstract:
Background: Hip fractures are among the most prevalent injuries in the elderly population, accounting for an estimated 1.66 million emergency orthopaedic operations per year. 50% of all hip fractures are intertrochanteric, and current National Institute for Health and Care Excellence guidelines recommend the use of extramedullary implants such as Dynamic Hip Screws (DHS) for their management. There are two common draping techniques for DHS fixation that allow positioning of intra-operative fluoroscopy. Traditional opaque drapes over the patient and vertical transparent isolation drapes. Our study aims to determine if there is a difference in radiation exposure between the two draping techniques.
Methods: Data was collected retrospectively over an 18-month period (February 2023 - July 2024) prior to transition to vertical isolation drapes and a 13-month period following (September 2024 - September 2025). Only surgeons who were consistently using the vertical isolation drapes were included. All DHS operations identified by the hospital coding team were included and procedure confirmed on review of intra-operative imaging and patient records.
Results: There were 56 patients included who had tradition draping technique and 65 patients who had vertical isolation draping. The mean radiation exposure time for the tradition draping group was 101.4 seconds. The mean radiation exposure time for the vertical isolation draping group was 84.8 seconds. The reduction in mean radiation exposure time between tradition draping and vertical isolation draping was 16.6 seconds (p=0.0736).
Conclusions: There was a 16.4% reduction in mean radiation exposure time following transition to the vertical isolation draping technique; however, this was found not to be statistically significant. Vertical isolation draping techniques reduce the number of drapes required for the dynamic hip screw fixation compared to traditional draping technique however, it remains unclear whether it provides any benefit in reducing radiation exposure to both the surgeon and patient. Prospective studies with larger sample sizes are required to further evaluate this association.
