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Radiation Exposure and Hand Dominance Using Mini C-Arm Fluoroscopy in Hand Surgery

机译：微型C型臂透视术在手外科手术中的放射线照射和手部优势

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Since R?ntgen’s landmark discovery of x-rays in 1895, fluoroscopy has become an integral surgical tool as well as significant source of radiation. Over the past 30 years, fluoroscopy use has grown, putting the surgeon at increased risk for radiation exposure. The effects of ionizing radiation exposure in humans are well documented and include skin burns, dermatitis, cataracts, and malignancy.4,8,14,18 With such dependence on fluoroscopy, orthopedic surgeons have been identified as being at higher risk for developing cancer than other hospital employees who routinely work with radiation.1,9The mini C-arm is a relatively new advancement that has become popular in hand surgery, as it has sought to increase portability as well as decrease radiation exposure in the intraoperative setting. There have been many studies in the past 10 years that have found a decreased risk of radiation exposure to the surgeon from mini C-arm compared with large C-arm.1,2,5,7,10,13,14,17,21 However, several recent studies have shown that the mini C-arm is still capable of generating considerable radiation exposure to the surgeon, especially if used with disregard to safety practices.6,16Several studies have sought to quantify how much radiation exposure a surgeon’s hands are exposed to during hand surgery using the mini C-arm.15,19,20 These studies were done with intraoperative dosimeters and vary considerably in the amount of radiation exposure reported to the hand surgeon’s hands. Despite many similarities in study design, they differ on which hand the ring dosimeter was worn. All hand surgeons at our institution consistently use their nondominant hand to maintain bone reduction and positioning, leaving their dominant hand free to use the wire driver. This places their nondominant hand much closer to, and occasionally directly in the radiation beam, putting their nondominant hand at risk for significant radiation exposure.We hypothesized that in hand surgery, the nondominant hand receives more radiation exposure than the dominant hand. The main purpose of this study is first to determine whether hand surgeons receive a different amount of radiation exposure to their hands based on hand dominance and second to provide a more accurate assessment of hand radiation exposure to the hand surgeon from mini C-arm fluoroscopy accounting for hand dominance.
机译：自从1895年伦琴（R？ntgen）具有里程碑意义的X射线发现以来，荧光透视法已成为不可或缺的外科手术工具以及重要的放射源。在过去的30年中，透视检查法的使用不断增长，使外科医生暴露于放射线的风险增加。电离辐射暴露对人类的影响已得到充分证明，包括皮肤灼伤，皮炎，白内障和恶性肿瘤。4,8,14,18由于对荧光检查的依赖性，骨科医生被确定为比罹患癌症的风险更高。 1,9微型C型臂是一种相对较新的进步，在手外科手术中很流行，因为它在手术过程中力求增加便携性并减少辐射暴露。在过去的10年中，有许多研究发现，与大型C形臂相比，迷你C形臂对外科医生辐射的风险降低了。1,2,5,7,10,13,14,17， 21然而，最近的几项研究表明，微型C型臂仍然能够对外科医生产生可观的放射线照射，尤其是在无视安全实践的情况下使用。6,16多项研究已试图量化外科医生的手受到的放射线照射量。 15、19、20这些研究是使用术中剂量计进行的，并且向手外科医生的手报告的辐射暴露量差异很大。尽管研究设计存在许多相似之处，但它们在佩戴环形剂量计的那只手上有所不同。我们机构中的所有手外科医师始终使用其非优势手来保持骨骼复位和定位，而其优势手则可以自由地使用钢丝钳。这会使他们的非优势手更靠近辐射，有时甚至直接位于辐射束中，从而使他们的非优势手处于显着辐射暴露的风险中。我们假设在手部手术中，非优势手比优势手受到的辐射更多。这项研究的主要目的是首先根据手的优势确定手外科医生是否接受不同程度的手部放射线照射，其次通过微型C型臂透视检查来更准确地评估手外科医生的手部放射线照射量。对于手的优势。

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