Variability in fluoroscopic image acquisition during operative fixation of ankle fractures

Dorothy Y. Harris, Ronald Lindsey

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The goal of this study was to determine whether injury, level of surgeon training, and patient factors are associated with increased use of fluoroscopy during open reduction and internal fixation of ankle fractures. These relationships are not well defined. The study was a retrospective chart review of patients treated at an academic institution with primary open reduction and internal fixation of an ankle. Patient demographics, including sex, age, and body mass index, were collected, as was surgeon year of training (residency and fellowship). Image acquisition data included total number of images, total imaging time, and cumulative dose. Ankle fractures were classified according to the Weber and Lauge-Hansen classifications and the number of fixation points. Bivariate analysis and multiple regression models were used to predict increasing fluoroscopic image acquisition. Alpha was set at 0.05. Of 158 patients identified, 58 were excluded. After bivariate analysis, fracture complexity and year of training showed a significant correlation with increasing image acquisition. After multiple regression analysis, fracture complexity and year of training remained clinically significant and were independent predictors of increased image acquisition. Increasing fracture complexity resulted in 20 additional images, 16 additional seconds, and an increase in radiation of 0.7 mGy. Increasing year of training resulted in an additional 6 images and an increase of 0.35 mGy in cumulative dose. The findings suggest that protocols to educate trainee surgeons in minimizing the use of fluoroscopy would be beneficial at all levels of training and should target multiple fracture patterns.

Original languageEnglish (US)
Pages (from-to)e864-e868
JournalOrthopedics
Volume38
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Ankle Fractures
Fluoroscopy
Regression Analysis
Internship and Residency
Systems Analysis
Ankle
Body Mass Index
Demography
Radiation
Wounds and Injuries
Surgeons

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Variability in fluoroscopic image acquisition during operative fixation of ankle fractures. / Harris, Dorothy Y.; Lindsey, Ronald.

In: Orthopedics, Vol. 38, No. 10, 01.10.2015, p. e864-e868.

Research output: Contribution to journalArticle

@article{aaffed9c4e864b138ca1abbbbef61653,
title = "Variability in fluoroscopic image acquisition during operative fixation of ankle fractures",
abstract = "The goal of this study was to determine whether injury, level of surgeon training, and patient factors are associated with increased use of fluoroscopy during open reduction and internal fixation of ankle fractures. These relationships are not well defined. The study was a retrospective chart review of patients treated at an academic institution with primary open reduction and internal fixation of an ankle. Patient demographics, including sex, age, and body mass index, were collected, as was surgeon year of training (residency and fellowship). Image acquisition data included total number of images, total imaging time, and cumulative dose. Ankle fractures were classified according to the Weber and Lauge-Hansen classifications and the number of fixation points. Bivariate analysis and multiple regression models were used to predict increasing fluoroscopic image acquisition. Alpha was set at 0.05. Of 158 patients identified, 58 were excluded. After bivariate analysis, fracture complexity and year of training showed a significant correlation with increasing image acquisition. After multiple regression analysis, fracture complexity and year of training remained clinically significant and were independent predictors of increased image acquisition. Increasing fracture complexity resulted in 20 additional images, 16 additional seconds, and an increase in radiation of 0.7 mGy. Increasing year of training resulted in an additional 6 images and an increase of 0.35 mGy in cumulative dose. The findings suggest that protocols to educate trainee surgeons in minimizing the use of fluoroscopy would be beneficial at all levels of training and should target multiple fracture patterns.",
author = "Harris, {Dorothy Y.} and Ronald Lindsey",
year = "2015",
month = "10",
day = "1",
doi = "10.3928/01477447-20151002-51",
language = "English (US)",
volume = "38",
pages = "e864--e868",
journal = "Orthopedics",
issn = "0147-7447",
publisher = "Slack Incorporated",
number = "10",

}

TY - JOUR

T1 - Variability in fluoroscopic image acquisition during operative fixation of ankle fractures

AU - Harris, Dorothy Y.

AU - Lindsey, Ronald

PY - 2015/10/1

Y1 - 2015/10/1

N2 - The goal of this study was to determine whether injury, level of surgeon training, and patient factors are associated with increased use of fluoroscopy during open reduction and internal fixation of ankle fractures. These relationships are not well defined. The study was a retrospective chart review of patients treated at an academic institution with primary open reduction and internal fixation of an ankle. Patient demographics, including sex, age, and body mass index, were collected, as was surgeon year of training (residency and fellowship). Image acquisition data included total number of images, total imaging time, and cumulative dose. Ankle fractures were classified according to the Weber and Lauge-Hansen classifications and the number of fixation points. Bivariate analysis and multiple regression models were used to predict increasing fluoroscopic image acquisition. Alpha was set at 0.05. Of 158 patients identified, 58 were excluded. After bivariate analysis, fracture complexity and year of training showed a significant correlation with increasing image acquisition. After multiple regression analysis, fracture complexity and year of training remained clinically significant and were independent predictors of increased image acquisition. Increasing fracture complexity resulted in 20 additional images, 16 additional seconds, and an increase in radiation of 0.7 mGy. Increasing year of training resulted in an additional 6 images and an increase of 0.35 mGy in cumulative dose. The findings suggest that protocols to educate trainee surgeons in minimizing the use of fluoroscopy would be beneficial at all levels of training and should target multiple fracture patterns.

AB - The goal of this study was to determine whether injury, level of surgeon training, and patient factors are associated with increased use of fluoroscopy during open reduction and internal fixation of ankle fractures. These relationships are not well defined. The study was a retrospective chart review of patients treated at an academic institution with primary open reduction and internal fixation of an ankle. Patient demographics, including sex, age, and body mass index, were collected, as was surgeon year of training (residency and fellowship). Image acquisition data included total number of images, total imaging time, and cumulative dose. Ankle fractures were classified according to the Weber and Lauge-Hansen classifications and the number of fixation points. Bivariate analysis and multiple regression models were used to predict increasing fluoroscopic image acquisition. Alpha was set at 0.05. Of 158 patients identified, 58 were excluded. After bivariate analysis, fracture complexity and year of training showed a significant correlation with increasing image acquisition. After multiple regression analysis, fracture complexity and year of training remained clinically significant and were independent predictors of increased image acquisition. Increasing fracture complexity resulted in 20 additional images, 16 additional seconds, and an increase in radiation of 0.7 mGy. Increasing year of training resulted in an additional 6 images and an increase of 0.35 mGy in cumulative dose. The findings suggest that protocols to educate trainee surgeons in minimizing the use of fluoroscopy would be beneficial at all levels of training and should target multiple fracture patterns.

UR - http://www.scopus.com/inward/record.url?scp=84944229080&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84944229080&partnerID=8YFLogxK

U2 - 10.3928/01477447-20151002-51

DO - 10.3928/01477447-20151002-51

M3 - Article

C2 - 26488779

AN - SCOPUS:84944229080

VL - 38

SP - e864-e868

JO - Orthopedics

JF - Orthopedics

SN - 0147-7447

IS - 10

ER -