Zak Lukas, Tiefenboeck Thomas M, Wozasek Gerald E
Department of Orthopedics and Trauma-Surgery, Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
J Clin Med. 2021 Aug 24;10(17):3781. doi: 10.3390/jcm10173781.
Computed tomography (CT) is an essential tool in orthopedic surgery but is known to be a method with that entails radiation exposure. CT increases the risk of developing fatal cancer, which should not be underestimated. However, patients with bone defects and/or deformities must frequently undergo numerous investigations during their treatment. CT is used for surgical planning, evaluating callus maturation, alignment measurement, length measurement, torsion measurement, and angiography. This study explores the indications in CT scans for limb lengthening and deformity correction and estimates the effective radiation dose. These results should help avoid unnecessary radiation exposure by narrowing the examination field and by providing explicit scanning indications. For this study, 19 posttraumatic patients were included after the bone reconstruction of 21 lower limbs. All patients underwent CT examinations during or after treatment with an external ring fixator. The mean effective dose was 3.27 mSv, with a mean cancer risk of 1:117,014. The effective dose depended on the location and indication of measurement, with a mean dose of 0.04 mSv at the ankle up to 6.8 mSv (or higher) for vascular depictions. CT evaluation, with or without 3D reconstruction, is a crucial tool in complex bone reconstruction and deformity treatments. Therefore, strict indications are necessary to reduce radiation exposure-especially in young patients-without compromising the management of their patients.
计算机断层扫描（CT）是骨科手术中的重要工具，但众所周知，它是一种会带来辐射暴露的方法。CT会增加患致命癌症的风险，这一点不可低估。然而，患有骨缺损和/或畸形的患者在治疗过程中必须频繁接受多项检查。CT用于手术规划、评估骨痂成熟度、对线测量、长度测量、扭转测量和血管造影。本研究探讨了CT扫描在肢体延长和畸形矫正中的适应证，并估算了有效辐射剂量。这些结果应有助于通过缩小检查范围和提供明确的扫描适应证来避免不必要的辐射暴露。在本研究中，纳入了19例创伤后患者，他们的21条下肢进行了骨重建。所有患者在使用外固定架治疗期间或之后均接受了CT检查。平均有效剂量为3.27 mSv，平均患癌风险为1:117,014。有效剂量取决于测量的部位和适应证，踝关节处的平均剂量为0.04 mSv，血管造影时可达6.8 mSv（或更高）。无论有无三维重建，CT评估都是复杂骨重建和畸形治疗中的关键工具。因此，严格的适应证对于减少辐射暴露（尤其是年轻患者）是必要的，同时又不影响对患者的治疗。
