THE USE OF MINI C-ARM MACHINES IN MINOR FOOT AND ANKLE PROCEDURES AND INJECTIONS SHOWS REDUCED COSTS AND CARBON EMISSIONS COMPARED TO TRADITIONAL C-ARM MACHINES IMPROVING ENVIRONMENTAL SUSTAINABILITY

The mini C-arm is a surgeon-operated smaller machine compared to the radiographer-operated traditional C-arm machine. There is limited data for the financial and environmental impact of the use of mini C-arms in minor foot and ankle procedures and injection cases. We did a cost and usage analysis including initial purchasing price and yearly operational expenditures of mini C-arms versus traditional C-arms, along with investigating the carbon emissions of each machine. We also studied aspects of the radiation impact of utilising mini C-arms. A database consisting of 156 minor foot and ankle procedures and injections was created. There were operational cost savings of £8,135.26 for the 156 cases over the course of one year when utilising mini C-arms instead of traditional C-arms, excluding radiation safety course fees. The traditional C-arms created 1.4 times increase in carbon emission output compared to mini C-arms, which demonstrated obvious environmental implications. A diagnostic reference level (DRL) was calculated for the database, producing a 48% lower value compared to the local DRL for foot and ankle imaging. The mini C-arm mean total dose area product (DAP) at 1.63cGy.cm2 was found to be reduced compared to the local DRL at 4cGy.cm2. For the minor foot and ankle procedures and injections of this study, mini C-arms have shown significant financial and environmental benefits compared to traditional C-arms. Radiation exposure benefits of the mini C-arms were also seen in this study. Further larger studies could help confirm our findings and determine best practice for the use of these machines.