Exploratory Study of Radiation Exposure between Image Intensifier-Equipped C-Arm and a Flat Panel Detector During Volar Plate Fixation of the Distal Radius.

Abstract

Background: To compare the amount of radiation exposure received by the surgeon during volar locking plate fixation for distal radius fractures using an image intensifier (II) and a flat panel detector (FPD). Methods: We included 40 patients who underwent open reduction and internal fixation using a volar locking plate for isolated distal radius fractures. Surgeons wore thermoluminescent dosimeter badges at six anatomical sites: both thumbs, thyroid, at eye level (to estimate the eye lens dose), chest (under the protector) and abdomen (under the protector). The badges were replaced monthly, and equivalent radiation doses were measured. Fluoroscopy time was recorded from operative notes. Sixteen cases operated using an II-equipped C-arm between August and October 2020 were classified as Group II. Twenty-four patients treated between September and November 2024 using an FPD-equipped system comprised Group FPD. Results: Operative time was similar between groups (57 vs. 56 minutes). Fluoroscopy time was 324 seconds in Group II and 239 seconds in Group FPD and air kerma per case was comparable (6.6 vs. 5.8 mGy). Equivalent dose per second was higher with FPD for both thumbs (right: 2.23 vs. 1.70 μSv/s; left: 9.57 vs. 2.07 μSv/s), with no significant differences in eye-lens or thyroid exposure. Conclusions: The equivalent radiation dose per second of fluoroscopy was significantly higher in Group FPD for both thumbs compared to II systems. No significant differences were observed in radiation exposure to the lens or thyroid between groups. Level of Evidence: Level IV (Therapeutic).