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Radiation exposure in the treatment of pediatric supracondylar humerus fractures

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To determine the factors that influence radiation exposure during repair of supracondylar humerus fractures.

Methods

Medical records of almost 200 children with supracondylar fractures were retrospectively analyzed for variables correlated with fluoroscopy time and radiation dose as measures of radiation exposure.

Results

There was no statistically significant difference in fluoroscopy time (27 vs. 22 s p = 0.345) or direct radiation dose (0.394 vs. 0.318 mSv p = 0.290) between uniplanar and biplanar C-arm use. No statistically significant differences in fluoroscopy time or radiation dose were found for surgical technique, comorbid ipsilateral fractures, preoperative neurovascular compromise, or resident participation. There was a significant 8.3 s increase in fluoroscopy time (p = 0.022) and 0.249 mSv increase in radiation dose (p = 0.020) as the fracture type increased from II to III. An increase in one pin during CRPP resulted in a statistically significant 10.4 s increase in fluoroscopy time and a 0.205 mSv increase in radiation dose. There were significant differences between the physician with the lowest fluoroscopy time and radiation dose compared with the physicians with the two highest values for both fluoroscopy time and radiation dose (p < 0.01).

Conclusions

We found no significant difference in direct radiation exposure or fluoroscopy time when comparing biplanar to uniplanar C-arm use, resident participation, preoperative neurovascular compromise, or for comorbid ipsilateral fractures. Both outcomes increased significantly as fracture type increased from II to III and as the number of pins used during CRPP increased. Both outcomes were significantly different between the surgeons performing CRPP.

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Funding

This study received no outside funding.

Author information

Authors and Affiliations

  1. Wright State University Boonshoft School of Medicine, Dayton, USA

    Alex Schmucker & Roy Chen

  2. Division of Neurosurgery and Department of Pediatrics, Dayton Children’s Hospital and Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA

    Shobhan Vachhrajani

  3. Department of Pediatric Orthopaedics, Dayton Children’s Hospital, One Children’s Plaza, Dayton, OH, 45404, USA

    Melissa Martinek & Michael Albert

Authors
  1. Alex Schmucker
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  2. Roy Chen
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  3. Shobhan Vachhrajani
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  4. Melissa Martinek
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  5. Michael Albert
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Corresponding author

Correspondence to Michael Albert.

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Conflict of interest

Author Alex Schmucker, Author Roy Chen, Author Shobhan Vachhrajani, Author Melissa Martinek, and Author Michael Albert declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. The study IRB approval as a retrospective chart review. This study was reviewed and approved by the Institutional Review Board of the academic healthcare facility where patients were seen.

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Schmucker, A., Chen, R., Vachhrajani, S. et al. Radiation exposure in the treatment of pediatric supracondylar humerus fractures. Arch Orthop Trauma Surg 140, 449–455 (2020). https://doi.org/10.1007/s00402-019-03251-2

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  • DOI: https://doi.org/10.1007/s00402-019-03251-2

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