Study on the radiation of C-arm X-ray machine to the non-surgical sites of patients undergoing orthopedic surgery

Objective To investigate the radiation dose and radiation protection strategy of C-arm X-ray machine (C-arm machine for short) on non-surgical sites of orthopedic trauma patients.

Methods A total of 456 patients who underwent orthopedic surgery under general anesthesia were selected as research objects and divided into protected group and unprotected group according to whether lead blanket was used or not. The same brand C-arm machine was used for positioning and diagnosis during the operation. In the unprotected group, lead blanket was not used during the operation, the difference of radiation dose in the non-surgical site was compared, and the influence of irradiation times on the radiation dose in the non-surgical site was analyzed. Lead blankets were used to protect the non-surgical sites in the protective group during the operation, and the difference of radiation dose in the non-surgical sites was compared between the two groups.

Results In the unprotected group, there were statistically significant differences in the radiation dose of different non-surgical sites in patients with the same surgical site (P < 0.05). The highest radiation dose of humeral surgery was in the thorax and waist, while that of femur and tibia and fibula surgery was in the perineum. In the unprotected group with different sites of surgery, the radiation dose of the key protected site in patients with ≥ 4 times of exposures was more than that of patients with < 4 times of exposures (P < 0.05). In the protection group, the radiation dose in the perineum of humerus operation, femur operation and tibia and fibula operation were (87.94±20.44), (111.69±19.03), (71.13±21.09) μGy/h, respectively, which were lower than (426.65±92.49), (448.78±85.20) and (370.56±62.15) μGy/h, respectively in the unprotected group (P < 0.05).

Conclusion The closer the distance to the surgical site and the more intraoperative C-arm irradiation times is, the higher the radiation dose received by the patients in the non-surgical site of orthopedic trauma surgery will be. The use of lead blanket protection could effectively reduce the radiation dose of the non-surgical site. Medical staff should take appropriate protective measures to protect the vital organs close to the surgical site of the patient so as to avoid radiation damage.