Measurement of radiation exposure when using the mini C-Arm to Reduce Pediatric Upper Extremity Fractures

Michael J. Sumko, William Hennrikus, Jennifer Slough, Kelly Jensen, Douglas Armstrong, Stephen King, Kenneth Urish

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Previous literature has underreported radiation exposure with the use of mini C-arm during pediatric forearm fracture reductions. The purpose of this study is to report an accurate amount of radiation exposure during fracture reductions using a mini C-arm that records the amount of kilovolts, milliamps, and the number of seconds of foot pedal use. Methods: Eighty-six consecutive pediatric patients undergoing upper extremity fracture reduction in the emergency department were studied. The orthopaedic resident, either a PGY2 or PGY3, performed a manipulative reduction and casting of the fracture with use of the mini C-arm. Postreduction, in cast, anteroposterior and lateral images from the mini C-arm were saved to the computerized radiology system. The mini C-arm recorded the amount of kilovolts, milliamps, and the number of seconds that the foot pedal was used for each reduction. A radiology physicist (S.K.) calculated the amount of millirem (mR) exposure for each reduction from these data. Results: The resident using the mini C-arm and the fracture pattern affected the amount of radiation exposure. The average mini C-arm mR exposure for distal radius fractures was 63 mR; forearm 109 mR; elbow 53 mR; and hand 69 mR. For comparison, conventional anteroposterior/lateral forearm radiographs emit an average of 20 mR. Less-experienced PGY2 residents had a higher mR exposure per reduction compared with PGY3 residents. Conclusions: Radiation exposure when using the mini C-arm for reduction of pediatric fractures has been underestimated in previous literature. Radiation from the mini C-arm exceeded that from conventional radiographs in most cases. We recommend that residents receive training about the use of the mini Carm before its utilization as an aid to reduce pediatric fractures in the emergency department. Level of Evidence/Clinical Relevance: Prospective study to evaluate the total amount of radiation exposure per pediatric forearm fracture reduction.

Original languageEnglish (US)
Pages (from-to)122-125
Number of pages4
JournalJournal of Pediatric Orthopaedics
Volume36
Issue number2
DOIs
StatePublished - Jan 1 2016

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Upper Extremity
Fracture Fixation
Arm
Pediatrics
Forearm
Foot
Radiology
Hospital Emergency Service
Radiation Exposure
Radius Fractures
Elbow
Orthopedics
Hand
Prospective Studies
Radiation

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

Cite this

Sumko, Michael J. ; Hennrikus, William ; Slough, Jennifer ; Jensen, Kelly ; Armstrong, Douglas ; King, Stephen ; Urish, Kenneth. / Measurement of radiation exposure when using the mini C-Arm to Reduce Pediatric Upper Extremity Fractures. In: Journal of Pediatric Orthopaedics. 2016 ; Vol. 36, No. 2. pp. 122-125.
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abstract = "Background: Previous literature has underreported radiation exposure with the use of mini C-arm during pediatric forearm fracture reductions. The purpose of this study is to report an accurate amount of radiation exposure during fracture reductions using a mini C-arm that records the amount of kilovolts, milliamps, and the number of seconds of foot pedal use. Methods: Eighty-six consecutive pediatric patients undergoing upper extremity fracture reduction in the emergency department were studied. The orthopaedic resident, either a PGY2 or PGY3, performed a manipulative reduction and casting of the fracture with use of the mini C-arm. Postreduction, in cast, anteroposterior and lateral images from the mini C-arm were saved to the computerized radiology system. The mini C-arm recorded the amount of kilovolts, milliamps, and the number of seconds that the foot pedal was used for each reduction. A radiology physicist (S.K.) calculated the amount of millirem (mR) exposure for each reduction from these data. Results: The resident using the mini C-arm and the fracture pattern affected the amount of radiation exposure. The average mini C-arm mR exposure for distal radius fractures was 63 mR; forearm 109 mR; elbow 53 mR; and hand 69 mR. For comparison, conventional anteroposterior/lateral forearm radiographs emit an average of 20 mR. Less-experienced PGY2 residents had a higher mR exposure per reduction compared with PGY3 residents. Conclusions: Radiation exposure when using the mini C-arm for reduction of pediatric fractures has been underestimated in previous literature. Radiation from the mini C-arm exceeded that from conventional radiographs in most cases. We recommend that residents receive training about the use of the mini Carm before its utilization as an aid to reduce pediatric fractures in the emergency department. Level of Evidence/Clinical Relevance: Prospective study to evaluate the total amount of radiation exposure per pediatric forearm fracture reduction.",
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Measurement of radiation exposure when using the mini C-Arm to Reduce Pediatric Upper Extremity Fractures. / Sumko, Michael J.; Hennrikus, William; Slough, Jennifer; Jensen, Kelly; Armstrong, Douglas; King, Stephen; Urish, Kenneth.

In: Journal of Pediatric Orthopaedics, Vol. 36, No. 2, 01.01.2016, p. 122-125.

Research output: Contribution to journalArticle

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T1 - Measurement of radiation exposure when using the mini C-Arm to Reduce Pediatric Upper Extremity Fractures

AU - Sumko, Michael J.

AU - Hennrikus, William

AU - Slough, Jennifer

AU - Jensen, Kelly

AU - Armstrong, Douglas

AU - King, Stephen

AU - Urish, Kenneth

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N2 - Background: Previous literature has underreported radiation exposure with the use of mini C-arm during pediatric forearm fracture reductions. The purpose of this study is to report an accurate amount of radiation exposure during fracture reductions using a mini C-arm that records the amount of kilovolts, milliamps, and the number of seconds of foot pedal use. Methods: Eighty-six consecutive pediatric patients undergoing upper extremity fracture reduction in the emergency department were studied. The orthopaedic resident, either a PGY2 or PGY3, performed a manipulative reduction and casting of the fracture with use of the mini C-arm. Postreduction, in cast, anteroposterior and lateral images from the mini C-arm were saved to the computerized radiology system. The mini C-arm recorded the amount of kilovolts, milliamps, and the number of seconds that the foot pedal was used for each reduction. A radiology physicist (S.K.) calculated the amount of millirem (mR) exposure for each reduction from these data. Results: The resident using the mini C-arm and the fracture pattern affected the amount of radiation exposure. The average mini C-arm mR exposure for distal radius fractures was 63 mR; forearm 109 mR; elbow 53 mR; and hand 69 mR. For comparison, conventional anteroposterior/lateral forearm radiographs emit an average of 20 mR. Less-experienced PGY2 residents had a higher mR exposure per reduction compared with PGY3 residents. Conclusions: Radiation exposure when using the mini C-arm for reduction of pediatric fractures has been underestimated in previous literature. Radiation from the mini C-arm exceeded that from conventional radiographs in most cases. We recommend that residents receive training about the use of the mini Carm before its utilization as an aid to reduce pediatric fractures in the emergency department. Level of Evidence/Clinical Relevance: Prospective study to evaluate the total amount of radiation exposure per pediatric forearm fracture reduction.

AB - Background: Previous literature has underreported radiation exposure with the use of mini C-arm during pediatric forearm fracture reductions. The purpose of this study is to report an accurate amount of radiation exposure during fracture reductions using a mini C-arm that records the amount of kilovolts, milliamps, and the number of seconds of foot pedal use. Methods: Eighty-six consecutive pediatric patients undergoing upper extremity fracture reduction in the emergency department were studied. The orthopaedic resident, either a PGY2 or PGY3, performed a manipulative reduction and casting of the fracture with use of the mini C-arm. Postreduction, in cast, anteroposterior and lateral images from the mini C-arm were saved to the computerized radiology system. The mini C-arm recorded the amount of kilovolts, milliamps, and the number of seconds that the foot pedal was used for each reduction. A radiology physicist (S.K.) calculated the amount of millirem (mR) exposure for each reduction from these data. Results: The resident using the mini C-arm and the fracture pattern affected the amount of radiation exposure. The average mini C-arm mR exposure for distal radius fractures was 63 mR; forearm 109 mR; elbow 53 mR; and hand 69 mR. For comparison, conventional anteroposterior/lateral forearm radiographs emit an average of 20 mR. Less-experienced PGY2 residents had a higher mR exposure per reduction compared with PGY3 residents. Conclusions: Radiation exposure when using the mini C-arm for reduction of pediatric fractures has been underestimated in previous literature. Radiation from the mini C-arm exceeded that from conventional radiographs in most cases. We recommend that residents receive training about the use of the mini Carm before its utilization as an aid to reduce pediatric fractures in the emergency department. Level of Evidence/Clinical Relevance: Prospective study to evaluate the total amount of radiation exposure per pediatric forearm fracture reduction.

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