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微创创伤外科中能否测量透视辐射暴露?

Can fluoroscopy radiation exposure be measured in minimally invasive trauma surgery?

机构信息

Traumatology and Orthopedics Department, Saint-Roch Hospital, Nice University Hospital Center, 5, rue Pierre-Dévoluy, 06000 Nice, France.

出版信息

Orthop Traumatol Surg Res. 2011 Oct;97(6):662-7. doi: 10.1016/j.otsr.2011.03.024. Epub 2011 Sep 22.


DOI:10.1016/j.otsr.2011.03.024
PMID:21943776
Abstract

Repeated use of X-rays in orthopedic surgery poses the problem of irradiation of patient and caregivers. Seven common minimally invasive bone trauma surgical procedures requiring image intensifier use were investigated: percutaneous K-wire fixation of the wrist, minimally invasive fixation plating of the wrist, percutaneous intramedullary nailing of the tibia and of the femur, short and long trochanteric nail fixation of trochanteric and sub-trochanteric fracture, and percutaneous fixation of thoracolumbar fracture. The study analyzed three parameters: dose area product (DAP), radiation duration, and skin entrance dose (SED). Data were collected from 15 successive implementations of each procedure. The aim of the study was to establish a database for this kind of bone trauma surgery and a hierarchy of the X-ray doses delivered. Percutaneous spinal osteosynthesis involved the highest dose, followed in decreasing order by long trochanteric nailing, femoral nailing, short trochanteric nailing, tibial nailing, wrist K-wire fixation and frontal wrist plate osteosynthesis. One short trochanteric nail procedure delivered the same DAP as 13 wrist K-wire fixation procedures, and one spinal osteosynthesis was equivalent to 13 short trochanteric nail or 174 wrist K-wire procedures. The anatomic area X-rayed appeared to be the main radiation dose factor. A database was established, but actual patient and staff radiation levels remained unknown.

摘要

在骨科手术中反复使用 X 射线会给患者和护理人员带来辐射问题。研究了七种常见的微创骨创伤手术,这些手术都需要使用影像增强器:腕部经皮 K 线固定术、腕部微创接骨板固定术、胫骨和股骨经皮髓内钉固定术、转子间和转子下骨折的短和长转子钉钉固定术以及胸腰椎骨折的经皮固定术。该研究分析了三个参数:剂量面积乘积(DAP)、辐射持续时间和皮肤入口剂量(SED)。从每个手术的 15 次连续实施中收集数据。研究的目的是为这种骨创伤手术建立一个数据库,并确定 X 射线剂量的等级。经皮脊柱骨合成术的剂量最高,其次是长转子钉钉固定术、股骨钉钉固定术、短转子钉钉固定术、胫骨钉钉固定术、腕部 K 线固定术和腕部前路接骨板固定术。一次短转子钉钉固定术的 DAP 与 13 次腕部 K 线固定术相同,一次脊柱骨合成术相当于 13 次短转子钉钉固定术或 174 次腕部 K 线固定术。被照射的解剖区域似乎是主要的辐射剂量因素。虽然已经建立了一个数据库,但实际的患者和工作人员的辐射水平仍然未知。

相似文献

[1]
Can fluoroscopy radiation exposure be measured in minimally invasive trauma surgery?

Orthop Traumatol Surg Res. 2011-9-22

[2]
[Minimally invasive therapeutic concepts in fracture surgery].

Z Arztl Fortbild Qualitatssich. 1999-6

[3]
A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia.

J Bone Joint Surg Br. 2010-7

[4]
Locked minimally invasive plating versus fourth generation nailing in the treatment of AO/OTA 31A2.2 fractures: A biomechanical comparison of PCCP(®) and Intertan nail(®).

Injury. 2015-8

[5]
Computer-assisted trauma surgery.

J Am Acad Orthop Surg. 2010-5

[6]
Quantification of radiation exposure in the operating theatre during management of common fractures of the upper extremity in children.

Ann R Coll Surg Engl. 2016-9

[7]
Trochanteric versus piriformis entry portal for the treatment of femoral shaft fractures.

J Orthop Trauma. 2006

[8]
Interlocking nails and minimally invasive osteosynthesis.

Vet Clin North Am Small Anim Pract. 2012-9

[9]
[Locked plating with minimally invasive percutaneous plate osteosynthesis versus intramedullary nailing of distal extra-articular tibial fracture: a retrospective study].

Zhonghua Yi Xue Za Zhi. 2013-12-17

[10]
[Treatment of trochanteric fractures by percutaneous compression plate].

Acta Chir Orthop Traumatol Cech. 2009-6

引用本文的文献

[1]
Influence of direct radiography in decision making during orthopaedic trauma surgery: A prospective study.

J Orthop. 2022-10-7

[2]
Radiation exposure during proximal femoral nailing: Traction table versus conventional table.

Jt Dis Relat Surg. 2022

[3]
Cavus Foot Correction Using a Full Percutaneous Procedure: A Case Series.

Int J Environ Res Public Health. 2021-9-25

[4]
Typical air kerma area product values for trauma orthopaedic surgical procedures.

Radiol Oncol. 2021-1-12

[5]
Radiation Exposure in Patients with Isolated Limb Trauma: Acceptable or Are We Imaging Too Much?

J Clin Med. 2020-11-9

[6]
Does a fluoro-assisted direct anterior approach for total hip arthroplasty pose an excessive risk of radiation exposure to the surgeon?

SICOT J. 2020

[7]
Electromagnetic distal targeting system does not reduce the overall operative time of the intramedullary nailing for humeral shaft fractures.

J Orthop. 2018-8-24

[8]
Patient dose reference levels in surgery: a multicenter study.

Eur Radiol. 2018-8-1

[9]
The Effect of C-Arm Mobility and Field of Vision on Radiation Exposure in the Treatment of Proximal Femoral Fractures: A Randomized Clinical Trial.

Biomed Res Int. 2018-3-27

[10]
Intra-operative fluoroscopic radiation exposure in orthopaedic trauma theatre.

Eur J Orthop Surg Traumatol. 2018-1

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