The Effect of Patient Position on the Fluoroscopy Doses Received in Hip Fracture Surgery

Aim: The study evaluates the impact of patient positioning on radiation doses received during fluoroscopy in proximal femoral nailing for hip fractures. With the increasing use of minimally invasive, imaging-guided procedures, it is crucial to assess radiation exposure risks to both patients and healthcare workers. Prior research indicates that various factors, including patient positioning, can influence radiation doses. Materials and Methods: This study included patients who underwent proximal femoral nailing for hip fractures from January 2023 to May 2024. Patients’ positions were supine on a traction table, lateral decubitus position on a radiolucent table. Fluoroscopy data, including fluoroscopy time, dose-area product (DAP), and radiation dose, along with patient demographics and body mass index (BMI), were analyzed. Results: A total of 114 patients were included. There were no significant differences in demographic characteristics between the groups. The mean fluoroscopy time was 42.02±25.75 seconds, with no significant difference between positions. The mean radiation dose was 18.72±16.24 milligray (mGy), and the mean DAP was 3.50±3.07 Gy-cm², with no significant differences across positions. However, a statistically significant positive correlation was found between BMI values and dose mGy values (r=0.242, p=0.009). Similarly, a statistically significant positive correlation was observed between BMI values and DAP values (r=0.243, p=0.009). However, the mean number of fluoroscopic shots was significantly higher in the supine position compared to the lateral position. Conclusion: Patient positioning did not significantly affect fluoroscopy time or radiation dose proximal femoral nailing procedures for hip fractures. However, the number of fluoroscopic shots was lower in the lateral position. High BMI was positively correlated with dose mGy and DAP values except for time. The findings highlight the importance of considering BMI in radiation dose management and suggest that the lateral position may be preferable for minimizing radiation exposure.