Radiation Exposure in Operatively Treated Pediatric Femur Fracture Patients.

Abstract

Background: Children who sustain femur fractures are exposed to medical radiation as part of their treatment. In addition to standard radiographs and fluoroscopy, computerized tomography (CT) is a major source of ionizing radiation (IR). These patients frequently undergo CT scans during their treatment. The aim of the current study was to quantify the factors associated with greater IR exposure in children with operatively treated femur fractures and compare radiation exposure among those who received CT scans versus those who did not.

Methods: Thirty-eight patients below 18 years old with operatively treated traumatic femur fractures were included in the study. They fell into one of 2 groups: 1 received 1 or more CT scans (CT group), and the other did not receive a CT scan (non-CT scan). The 2 groups were then compared by total quantitative radiation exposure, age, BMI, location of the femur fracture, open versus closed fracture, and the presence versus absence of fracture displacement.

Results: The effective dose of IR exposure that occurred within the operating room (OR) made up 75.7%±27.4% of the total IR exposure among all patients. Patients in the CT group had over a 5-fold greater quantitative cumulative IR exposure compared with the non-CT group (P<0.0001). Furthermore, patients in the CT group were significantly older than (P=0.004) and had a greater BMI (P=0.045) than the non-CT group.

Conclusion: Children with pediatric femur fractures often exceed what is considered a low level of radiation. There is a significant difference in radiation exposure between pediatric femur fracture patients who receive 1 or more CT scans compared with those who do not receive a CT scan.

Level of evidence: Level III-retrospective cohort study.