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Trauma

IONISING RADIATION EXPOSURE IN PATIENTS WITH CIRCULAR FRAME TREATMENT OF DISTAL TIBIAL FRACTURES

British Limb Reconstruction Society (BLRS) AGM & Instructional Course



Abstract

Methods:

Total radiation exposure accumulated during circular frame treatment of distal tibial fractures was quantified in 47 patients treated by a single surgeon from March 2011 until Nov 2014. The radiation exposures for all relevant radiology procedures for the distal tibial injury were included to estimate the radiation risk to the patient.

Results:

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 0.025 mSv (interquartile range 0.013 – 0.162 and minimum to maximum 0.01–0.53). CT scanning is the only variable shown to be an independent predictor of cumulative radiation dose on multivariate analysis, with a 13 fold increase in overall exposure.

Conclusion:

Radiation exposure during treatment of distal tibial fractures with a circular frame in this group was well within reasonably safe limits. 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 (Ionising Radiation (Medical Exposure) Regulations 20001).