Fluoroscopy Exposure During Distal Radius Fracture Fixation: An Audit of Current Practice

Background Distal radius fractures (DRFs) are among the most common fractures in adults. Volar plate fixation is a widely used treatment. Intraoperative fluoroscopy is essential for confirming reduction and implant positioning, but it exposes patients and staff to ionising radiation. This Study was conducted to assess local practice, quantify radiation exposure, and help to establish national benchmarks for fluoroscopy usage and radiation exposure to improve patients' and staff safety. Methods A retrospective review of 106 consecutive patients undergoing volar plate fixation for DRFs was performed in William Harvey Hospital, Ashford, Kent, UK. Demographics, fracture type, surgical details, and intraoperative fluoroscopy parameters were collected, including screening time, number of exposures, dose area product (DAP), and air kerma (AK). Data were analysed by fracture type and surgeon grade. Results The cohort included 31 males and 75 females, with a mean age of 59 years. Most fractures were intra-articular (n = 93). All patients underwent volar plate fixation. The mean operative time was 73 minutes. Fluoroscopy exposure during distal radius fixation demonstrated a mean screening time of 24 seconds (range 0.1-111), with a mean of 43 exposures (range 5-209), a mean dose area product (DAP) of 4.75 µGy·m² (range 0.31-29.26), and a mean AK of 0.26 (range 0.01-9). Further subgroup analysis was performed to quantify exposure by surgeons' grade and fracture classification. Conclusion Intraoperative fluoroscopy during volar plate fixation of DRFs in our institution resulted in a mean DAP of 4.75 µGy·m² and a mean screening time of 24 seconds. No significant differences were observed by operator grade or fracture complexity. Future efforts should focus on standardising its collection and defining orthopaedic Diagnostic reference levels. Regular audit of fluoroscopy usage against established standards would help in improving uniformity across hospitals and orthopaedic teams.