Assessment of Radiation Protection Measures to Minimize Occupational Radiation Exposure from C-arm Fluoroscopy During Common Orthopaedic Surgical Procedures

Background: Modern fluoroscopic C-arms have substantially expanded the use of fluoroscopic C-arms in a variety of orthopaedic surgical procedures. Fluoroscopy professionals who are exposed to radiation for an extended period of time have an increased risk of developing radiation-induced cancer. The study aimed to evaluate the radiation protection precautions taken by theater staff in two selected hospitals to reduce occupational radiation doses during fluoroscopy-guided common orthopaedic surgeries. Methods: After examining the theatre records for three months in two selected hospitals in Sri Lanka, the three major orthopaedic surgeries for both hospitals were selected (Dynamic Hip Screw, Tibial Plateau Fracture, and Distal Radial Fracture). The study used a checklist for an unbiased observation, containing the internationally recommended guidelines for Fluoroscopy inside an interventional suit published in the International Commission on Radiological Protection (ICRP) 139 publication to check whether the theatre personnel followed the radiation protective measures during their procedures. Results: Fluoroscopy technical-based protective measures and the quality assurance-related criteria were satisfied to a 100% level. Both hospitals, A and B, did not have an adequate number of lead shielding devices to be utilized in theatres. A lack of individual exposure monitoring and the use of two dosimeters were identified as the main problems. Conclusions: The staff of both hospitals adhered to the standard international guidelines on radiation protection during C-arm guided orthopaedic surgeries despite the unavailability of a proper personal monitoring system.