Radiation exposure to equine surgeons during simulated digital radiography and fluoroscopy‐guided fracture fixation of the distal limb

OBJECTIVE: Despite known occupational radiation risks, data on exposure during digital radiography (DR) or fluoroscopy-guided equine fracture repair are lacking. This study quantified radiation doses to a model surgeon's hand, lenses, thyroid, and gonads, and assessed protective effects of radiation-reducing surgical gloves and attenuating ointment. STUDY DESIGN: Comparative, controlled, simulation-based study. ANIMAL/SAMPLE POPULATION: Anthropomorphic model. METHODS: Distal limb fracture fixation was simulated using a model with dosimeters at the region of the lenses, thyroid, gonads, drill-holding hand, and under a lead apron (fetal dose). Radiation was measured over 10 DR or 10 single-image fluoroscopy exposures, then repeated using radiation-reducing surgical gloves or ointment. RESULTS: All radiation doses were below occupational limits. Dosimeters placed at the level of the gonads (outside the gown) received the highest mean dose (DR: 6.87 ± 0.40 μSv; fluoroscopy: 0.98 ± 0.28 μSv), followed by thyroid (outside the gown) (DR: 2.60 ± 0.52 μSv; fluoroscopy: 0.48 ± 0.08 μSv), hand (DR: 2.02 ± 0.54 μSv; fluoroscopy: 0.32 ± 0.06 μSv) and lenses (DR: 1.25 ± 0.28 μSv; fluoroscopy: 0.23 ± 0.07 μSv). The lowest exposure was measured underneath the gown (fetal dose) (DR: 0.01 ± 0.01 μSv; fluoroscopy: 0.01 ± 0.01 μSv). DR exposure exceeded fluoroscopy at all sites (p < .001). Radiation-reducing surgical gloves significantly lowered hand dose (p < .001), whereas ointment had no effect (p = .54). Off-beam hand exposure from 10 images was approximately one-millionth of the annual dose limit. CONCLUSION: Image-guided equine distal limb fracture fixation results in minimal hand radiation exposure, relative to other regions of the body, with DR producing higher doses than single-image fluoroscopy. Radiation-reducing surgical gloves significantly lower hand exposure during DR procedures. CLINICAL SIGNIFICANCE: Radiation-reducing surgical gloves offer additional protection and are recommended during image-guided surgery. Whenever feasible, pulsed fluoroscopy should be preferred over DR.