Abstract
Intramedullary nailing is probably the best method of treating long bone fractures
in the lower limb. The operation is guided by fluoroscopy, for guide-wire insertion,
fracture reduction and distal locking. No study so far has measured the scatter radiation
to the patient’s gonads during intramedullary, particularly femoral, nailing. The
purpose here was to estimate the radiation hazard to the patients’ gonads and surgeons’
hands during intramedullary nailing for lower limb fractures. From April 1994 to June
1998, 184 consecutive patients had 224 nailings for lower limb fractures. Twenty-eight
patients had Marchetti–Vincenzi nails and the rest had Russell–Taylor nails. There
were 45 males and 40 females who had femoral nailing and 71 males and 28 females who
had tibial nailing. The mean (range) age for femoral nailing was 56 (17–95.5) years
and the mean age for tibia nailing was 44 (16.5–87.5) years. The average time of radiation
when done by consultants was half that of middle-grade surgeons. The mean tibial nailing
radiation time for the consultant was 0.56 min and for the middle-grade 1.28 min. The mean femoral nailing radiation time for the consultant was 0.52 min and for the middle-grade 1.61 min (P<0.05). The mean tibial and femoral nailing time were less for Marchetti nailing (P<0.05). Regular protection of the gonads of these patients is mandatory. This study
shows that the radiation exposure for Marchetti–Vincenzi nailing is significantly
less than for Russell–Taylor nailing. The overall radiation to patient gonads and
surgeon hands was within acceptable limits.
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Article info
Publication history
Accepted:
February 7,
2002
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
