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J Am Acad Orthop Surg, Vol 13, No 1, January/February 2005, 69-76.
© 2005 the American Academy of Orthopaedic Surgeons
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Occupational Radiation Exposure to the Surgeon

Gordon Singer, MD, MS

Dr. Singer is Hand and Upper Extremity Surgeon, Department of Orthopaedic Surgery, Kaiser Permanente, Denver, CO.

Reprint requests: Dr. Singer, Kaiser Permanente, 2045 Franklin Street, Denver, CO 80205.

Increased use of intraoperative fluoroscopy exposes the surgeon to significant amounts of radiation. The average yearly exposure of the public to ionizing radiation is 360 millirems (mrem), of which 300 mrem is from background radiation and 60 mrem from diagnostic radiographs. A chest radiograph exposes the patient to approximately 25 mrem and a hip radiograph to 500 mrem. A regular C-arm exposes the patient to approximately 1,200 to 4,000 mrem/min. The surgeon may receive exposure to the hands from the primary beam and to the rest of the body from scatter. Recommended yearly limits of radiation are 5,000 mrem to the torso and 50,000 mrem to the hands. Exposure to the hands may be higher than previously estimated, even from the mini C-arm. Potential decreases in radiation exposure can be accomplished by reduced exposure time; increased distance from the beam; increased shielding with gown, thyroid gland cover, gloves, and glasses; beam collimation; using the low-dose option; inverting the C-arm; and surgeon control of the C-arm.




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B. D. Giordano, S. Ryder, J. F. Baumhauer, and B. F. DiGiovanni
Exposure to Direct and Scatter Radiation with Use of Mini-C-Arm Fluoroscopy
J. Bone Joint Surg. Am., May 1, 2007; 89(5): 948 - 952.
[Abstract] [Full Text] [PDF]


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