1Departments of Orthopaedics (E.B.G., A.B.C., J.M.L., and M.M.M.) and Radiology (R.Z.), Hospital for Special Surgery, New York, NY.
J Bone Joint Surg Am. 2017 Aug 2;99(15):1324-1329. doi: 10.2106/JBJS.16.01557.
The purpose of this study was to determine the amount of cumulative radiation exposure received by orthopaedic surgeons and residents in various subspecialties. We obtained dosimeter measures over 12 months on 24 residents and 16 attending surgeons.
Monthly radiation exposure was measured over a 12-month period for 24 orthopaedic residents and 16 orthopaedic attending surgeons. The participants wore a Landauer Luxel dosimeter on the breast pocket of their lead apron. The dosimeters were exchanged every rotation (5 to 7 weeks) for the resident participants and every month for the attending surgeon participants. Radiation exposure was compared by orthopaedic subspecialty, level of training, and type of fluoroscopy used (regular C-arm compared with mini C-arm).
Orthopaedic residents participating in this study received monthly mean radiation exposures of 0.2 to 79 mrem/month, lower than the dose limits of 5,000 mrem/year recommended by the United States Nuclear Regulatory Commission (U.S. NRC). Senior residents rotating on trauma were exposed to the highest monthly radiation (79 mrem/month [range, 15 to 243 mrem/month]) compared with all other specialty rotations (p < 0.001). Similarly, attending orthopaedic surgeons who specialize in trauma or deformity surgery received the highest radiation exposure of their peers, and the mean exposure was 53 mrem/month (range, 0 to 355 mrem/month).
Residents and attending surgeons performing trauma or deformity surgical procedures are exposed to significantly higher doses of radiation compared with all other subspecialties within orthopaedic surgery, but the doses are still within the recommended limits.
The use of ionizing radiation in the operating room has become an indispensable part of orthopaedic surgery. Although all surgeons in our study received lower than the yearly recommended dose limit, it is important to be aware of how much radiation we are exposed to as surgeons and to take measures to further limit that exposure.
本研究旨在确定不同骨科亚专业的骨科医生和住院医师累积辐射暴露量。我们在 12 个月内对 24 名住院医师和 16 名主治医生进行了剂量计测量。
在 12 个月的时间内，对 24 名骨科住院医师和 16 名骨科主治医生进行了每月的辐射暴露测量。参与者将 Landauer Luxel 剂量计佩戴在铅围裙的胸袋上。对于住院医师参与者，每轮（5 至 7 周）更换一次剂量计，对于主治外科医生参与者，每月更换一次剂量计。按骨科亚专业、培训水平和使用的透视类型（常规 C 臂与微型 C 臂）比较辐射暴露。
参与本研究的骨科住院医师每月平均辐射暴露量为 0.2 至 79 mrem/月，低于美国核监管委员会（美国核管会）推荐的 5000 mrem/年剂量限制。从事创伤的高年住院医师的每月辐射暴露量最高（79 mrem/月[范围，15 至 243 mrem/月]），与所有其他专业轮次相比（p < 0.001）。同样，专门从事创伤或畸形手术的骨科主治医生的辐射暴露量最高，平均为 53 mrem/月（范围，0 至 355 mrem/月）。
与骨科手术的所有其他亚专业相比，进行创伤或畸形手术的住院医师和主治医生受到的辐射剂量明显更高，但这些剂量仍在推荐范围内。
在手术室中使用电离辐射已成为骨科手术不可或缺的一部分。尽管我们研究中的所有外科医生都接受的辐射剂量低于每年推荐的剂量限制，但了解我们作为外科医生所接受的辐射量以及采取措施进一步限制这种暴露非常重要。
