Imaging in Fracture surgeries - a tool for quality assessment

Radiation in orthopaedic surgeries was considered to be commonly hazardous, but also can be used as tool to improvise the surgical skills, limitations of exposure, risk analysis and making of alternate arrangements whenever required. We aim to analyse the number of times of imaging taken intra-operatively with C-arm for all acute closed lower limb fractures, which are all electively planned for intramedullary nailing fixation. It was a single centre, prospective randomized control double blind study, acute closed single plane fracture of lower limb like tibia shaft fracture, femur shaft fracture and intertrochanteric fracture electively posted for intramedullary nailing fixation were included. Total of 168 fractures, 38 intertrochanteric fractures (22.61%), 52 femur shaft fractures (30.95%), 78 tibia shaft fractures (46.42%) were electively planned for nailing fixation with intra-operative image guidance. Mean age was 42 which was statistically significant. Males were more than females, (89 male 52.97% and 79 female 47.02%) observed to be statistically not significant. Right lower limb 90 (53.57%) was observed to be more injured than the left lower limb 78(46.42%) which was statistically not significant (p<0.56). Mean imaging for intramedullary fixation in intertrochanteric fractures was 75 (17.30%) , femur 120 (37.76%) and tibia 95 (44.93%) was observed to be statistically significant. Radiation in orthopaedic surgeries can be otherwise and also be utilized by operating primary trauma surgeon with focus on average number of imaging for the elective nailing procedure as a self-monitoring tool for skill improvement with reproducible potential, radiation minimisation, call for help and technical improvisation for the future years, besides its occupational ill effects.