Radiation exposure during proximal femoral nailing: Traction table versus conventional table

Abstract

Objectives: The aim of this study was to compare radiation exposure of the patient during the closed reduction and proximal femoral nailing (PFN) of the trochanteric region fractures of the proximal femur using a traction table (TT) or a radiolucent table (RT) in the supine position.

Patients and methods: Between June 2019 and December 2020, the study included 42 patients (19 males, 23 females; mean age: 81.2±9.5 years; range, 60 to 97 years) with trochanteric region fractures applied with closed reduction and PFN with the same implant type, 21 who underwent surgery on a TT (TT group), and 21 on a RT (RT group). The cumulative radiation dose was the primary outcome and was measured as the dose area product (DAP) in Gray cm² (Gycm² ). Intraoperative fluoroscopy times and amount of radiation exposure were compared between the two groups.

Results: There was no significant difference between the two groups in terms of sex, age, body mass index, fracture side, and the AO Foundation/Orthopaedic Trauma Association (AO/OTA) fracture classification (p>0.05). No statistically significant difference was found between the TT and RT groups in terms of the mean intraoperative fluoroscopy time (48.29±22.31 and 55.95±21.54 sec, respectively; p=0.264) and amount of radiation exposure (2.26±1.86 and 2.84±1.96 Gycm² , respectively; p=0.332).

Conclusion: Both TT and RT with the patient positioned supine provide similar results for closed reduction and PFN of trochanteric region fractures, in terms of DAP as the most reliable measurement method. The main clinical relevance of this study is that radiation exposure of the patient need not be considered while selecting the operating table.

Citation: Bilekli AB, Bahtiyar EE, Zeybek H, Neyişci Ç, Erdem Y, Çankaya D. Radiation exposure during proximal femoral nailing: Traction table versus conventional table. Jt Dis Relat Surg 2022;33(2):338-344.

The study protocol was approved by the Gülhane Training and Research Hospital Ethics Committee (Date: 11.30.2020/no: 2020-475). The study was conducted in accordance with the principles of the Declaration of Helsinki.

A written informed consent was obtained from each patient.
Data Sharing Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Study conception and design: A.B.B., D.Ç.; Data collection: A.B.B., Ç.N., H.Z.; Analysis and interpretation of results: A.B.B., E.E.B., Ç.N., H.Z.; Draft manuscript preparation: A.B.B., Y.E., D.Ç.; All authors reviewed the results and approved the final version of the manuscript.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.