Differences in Intraoperative Fluoroscopic Radiation Exposure During Ankle Fracture Open Reduction and Internal Fixation Between Orthopaedic Surgery and Podiatry.


Journal

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
ISSN: 2474-7661
Titre abrégé: J Am Acad Orthop Surg Glob Res Rev
Pays: United States
ID NLM: 101724868

Informations de publication

Date de publication:
01 Jun 2024
Historique:
received: 05 04 2024
accepted: 11 04 2024
medline: 30 5 2024
pubmed: 30 5 2024
entrez: 30 5 2024
Statut: epublish

Résumé

Surgical ankle fractures pose a unique situation because both podiatrists and orthopaedic surgeons manage these injuries. Intraoperative fluoroscopy is routinely used; however, excessive radiation can be harmful to both the patient and the surgical team. The primary goal of this study was to determine whether there is a difference in the amount of intraoperative radiation exposure during ankle fracture open reduction and internal fixation (ORIF) when performed by orthopaedic surgeons versus podiatrists. This is a retrospective review of patients who underwent ankle fracture ORIF at an urban level I trauma center between January 1st, 2018, and April 1st, 2023. The electronic health record was queried using International Classification of Diseases nine and 10 codes associated with ankle fractures. Patients aged older than 18 years with an ankle fracture managed surgically were included. Subjects were then stratified by procedure. The mean total radiation dose (mRad) and mean total fluoroscopic time (seconds) were then compared between those performed by orthopaedic surgeons and podiatrists. Of the 333 included procedures, 186 were done by orthopaedic surgeons and 147 were done by podiatrists. Using multiple linear regression analysis to control for age, sex, race, ethnicity, and body mass index, patients undergoing isolated malleolus ORIF with syndesmosis repair performed by orthopaedic surgery were found to have a significantly lower mean fluoroscopic time compared with those performed by podiatry (68.4 s versus 104.8 s; P = 0.028). In addition, trimalleolar ORIF with syndesmotic repair performed by orthopaedic surgery had a significantly lower mean total radiation dose compared with those performed by podiatry (244.6 mRad v 565.6 mRad; P = 0.009). Patients and surgical teams are exposed to markedly less radiation in isolated malleolar and trimalleolar fracture ORIF with syndesmosis repair when performed by an orthopaedic surgeon as compared with those performed by a podiatrist.

Identifiants

pubmed: 38814258
doi: 10.5435/JAAOSGlobal-D-24-00131
pii: 01979360-202406000-00001
doi:

Types de publication

Journal Article Comparative Study

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.

Références

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Auteurs

Monica DiFiori (M)

Department of Orthopaedics and Sports Medicine, Temple University Hospital, Philadelphia, PA (Dr. DiFiori and Dr. Bires); Lancaster Orthopaedic Group, Lancaster General Hospital, Lancaster, PA (Dr. Luginbuhl); Department of Orthopaedics, St. Josephs University Medical Center, Paterson, NJ (Dr. Rallis); Trinity Health Mid-Atlantic, St. Mary Medical Center, Langhorne, PA (Dr. Gokcen).

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