Defining reference levels for intra-operative radiation exposure in orthopaedic trauma: A retrospective multicentre study

In plain language

Across 495 orthopaedic trauma operations in four London hospitals, the authors set fluoroscopy reference levels (DAP and screening time) for five common procedures. These benchmarks support audit of local practice; staff dose was not measured.

At a glance

Type of study: Original research, Retrospective cohort study
Who was studied: Orthopedic surgeons, Trainees, Patients
Size: n = 495 procedures
Where: United Kingdom
Topics: Patient dose Dose reduction techniques Dosimetry and monitoring
Summary based on: the abstract

What it found

Reference levels (third quartile) were defined for five common orthopaedic trauma procedures; e.g. dynamic hip screw and intramedullary femoral nail had the highest dose-area product (DAP) values.
Key figures: DHS 1.9225000 Gycm(2)/70.50 s; IM femoral nail 1.5837500 Gycm(2)/126.00 s
Upper-limb and ankle fixation procedures had much lower reference levels.
Key figures: ORIF clavicle 0.2042500 Gycm(2)/21.50 s; ORIF lateral malleolus 0.32250500 Gycm(2)/35.00 s; ORIF distal radius 0.1300000 Gycm(2)/56.00 s
Surgeon grade did not affect exposure for dynamic hip screw but was inversely related to exposure for intramedullary femoral nailing.
Exposure time varied less than DAP.
Data came from 495 procedures in four Greater London hospitals over one year.
Key figures: 495 procedures; 4 hospitals

Limits to keep in mind

Retrospective abstract-level data from four London hospitals; measures patient-side exposure metrics (DAP, time) rather than staff dose or health outcomes.

AST Standards for Ionizing Radiation Exposure (Guideline or consensus statement)
ICRP Draft - Radiological Protection in Fluoroscopically Guided Procedures (Guideline or consensus statement)
Factors Contributing To Radiation Dose For Patients And Operators During Diagnostic Cardiac Angiography (2018, Retrospective cohort study)
Comparison of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease with Flat-Panel Detectors on Mobile C-arm versus Fixed Systems (2017, Prospective cohort study)
Modern Fixed Imaging Systems Reduce Radiation Exposure To Patients And Providers (2017, Retrospective cohort study)

How this summary was made

ORSIF prepared this summary with AI assistance from the abstract of the paper. A program then checked that the passage supporting each finding appears word for word in that source. A person has not yet reviewed each summary, so read the original before relying on a number. ORSIF summarizes research and does not endorse any product or company. Report a problem with this summary.

Prepared November 3, 2026.