AB154. SOH25_AB_211. Direct intra-operative radiation exposure among plastic hand surgeons
Orthopaedic Session II

AB154. SOH25_AB_211. Direct intra-operative radiation exposure among plastic hand surgeons

Iulia Marinescu1, Sean Curran2, Khairun Izlinda Abdul Jalil3, Roisin Dolan1, Paul Sullivan2, Nicholas Startford3

1Department of Plastic and Reconstructive Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Plastic and Reconstructive Surgery, Connolly Hospital Blanchardstown, Dublin, Ireland; 3Department of Plastic and Reconstructive Surgery, St. Vincent’s University Hospital, Dublin, Ireland

Background: Intra-operative imaging is crucial in the management of hand fractures, to preserve function and range of motion. However, radiographs carry a risk for both direct and indirect radiation exposure to the operating staff, which can be detrimental to their health in the long term. Exposure of surgeons’ hands to radiation intra-operatively often occurs due to a need for close manual manipulation of the patient’s digits, the need to maintain stability, and time pressure. This study aims to assess the prevalence of non-patient digits appearing in saved intra-operative radiographs and elucidate prevention strategies.

Methods: A multi-centre retrospective analysis of hand surgery cases during which intra-operative fluoroscopy was used was performed. Data was extracted from intra-operative imaging records stored in the Picture Archiving and Communication System (PACS). A literature review was performed to identify techniques that can be used to reduce surgeon exposure to direct radiation.

Results: A total of 185 procedures performed between 2022 and 2024 were included. Non-patient digits were present in intra-operative radiographs in 24% of cases. Most of them were performed by consultants (61.36%) and during normal working hours (75%). These factors were not significant predictors of the results (P>0.05). Risks can be minimised while maintaining surgical and imaging accuracy by the use of various instruments to aid with patient digit positioning and using personal protective equipment such as lead gloves.

Conclusions: The study highlights a need for specific recommendations related to training, use of protective equipment, and positioning protocols in order to reduce the risk of surgeons’ exposure to radiation.

Keywords: Hand surgery; radiation; safety; intra-operative imaging; exposure

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab154
Cite this abstract as: Marinescu I, Curran S, Abdul Jalil KI, Dolan R, Sullivan P, Startford N. AB154. SOH25_AB_211. Direct intra-operative radiation exposure among plastic hand surgeons. Mesentery Peritoneum 2025;9:AB154.

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