Abstract：
BACKGROUND: Elastic stable intramedullary nailing (ESIN) is a well-defined and appropriate treatment of choice for long bone fractures. Despite its benefits, the risk of cancer from imaging devices is of particular concern for younger adults. So, this survey was conducted to estimate the doses administered to patients undergoing ESIN of long bone fractures utilizing a 2-dimensional (2D) C-arm fluoroscopy machine during surgery, as well as the carcinogenic risk associated with the use of the machine.
METHODS: This study was conducted on 147 patients who required ESIN for long-bone fractures. Patients\' demographic data, surgical data and imaging information were collected. For each patient, the organ doses and the effective doses were computed with the Monte Carlo PCXMC 2.0 simulation software. The cancer risk models proposed in the Biological Effects of Ionizing Radiation VII (BEIR VII) Phase 2 report were used to evaluate the risk of exposure-induced cancer death (REID) values.
RESULTS: For all patients, the highest organ dose was delivered to the gonads. The mean effective dose was 0.026 ± 0.015 mSv and 1.3E-04 ± 1E-04 mSv for ESIN of femur and tibia fractures, respectively. Males had a mean REID of 1 per million, while females had a mean REID of 0.19 per million. The younger males had considerably higher REID values. The effective dose was significantly correlated with age, gender, and irradiation time.
CONCLUSIONS: Low levels of effective doses and cancer risks associated with the utilization of the fluoroscopy machine in current practice were found in ESIN treatment of long-bone fractures.
CONCLUSIONS: This outcome will help to raise surgeons\' awareness of radiation risks and encourage them to initiate measures to keep radiation dose and exposure time as low as reasonably achievable.
METHODS: This study was conducted on 147 patients who required ESIN for long-bone fractures. Patients\' demographic data, surgical data and imaging information were collected. For each patient, the organ doses and the effective doses were computed with the Monte Carlo PCXMC 2.0 simulation software. The cancer risk models proposed in the Biological Effects of Ionizing Radiation VII (BEIR VII) Phase 2 report were used to evaluate the risk of exposure-induced cancer death (REID) values.
RESULTS: For all patients, the highest organ dose was delivered to the gonads. The mean effective dose was 0.026 ± 0.015 mSv and 1.3E-04 ± 1E-04 mSv for ESIN of femur and tibia fractures, respectively. Males had a mean REID of 1 per million, while females had a mean REID of 0.19 per million. The younger males had considerably higher REID values. The effective dose was significantly correlated with age, gender, and irradiation time.
CONCLUSIONS: Low levels of effective doses and cancer risks associated with the utilization of the fluoroscopy machine in current practice were found in ESIN treatment of long-bone fractures.
CONCLUSIONS: This outcome will help to raise surgeons\' awareness of radiation risks and encourage them to initiate measures to keep radiation dose and exposure time as low as reasonably achievable.
摘要：
背景：弹性稳定髓内钉（ESIN）是一种定义明确且合适的长骨骨折治疗方法。尽管有好处,来自成像设备的癌症风险对于年轻成年人尤其值得关注.所以,这项调查是为了估计在手术过程中使用二维（2D）C臂透视机接受长骨骨折ESIN治疗的患者的剂量，以及与使用机器相关的致癌风险。
方法：本研究对147例长骨骨折需要ESIN的患者进行。患者人口统计数据，收集手术数据和影像学信息.对于每个病人来说,使用蒙特卡罗PCXMC2.0模拟软件计算器官剂量和有效剂量。电离辐射生物效应VII（BEIRVII）2期报告中提出的癌症风险模型用于评估暴露诱导的癌症死亡（REID）值的风险。
结果：对于所有患者，最高的器官剂量被送到性腺。股骨和胫骨骨折ESIN的平均有效剂量为0.026±0.015mSv和1.3E-04±1E-04mSv，分别。男性的平均REID为百万分之一，而女性的平均REID为百万分之0.19。年轻男性的REID值要高得多。有效剂量与年龄显著相关,性别,和照射时间。
结论：在目前的实践中，在长骨骨折的ESIN治疗中，与透视机的使用相关的有效剂量和癌症风险较低。
结论：这一结果将有助于提高外科医生对辐射风险的认识，并鼓励他们采取措施，使辐射剂量和暴露时间尽可能低。
方法：本研究对147例长骨骨折需要ESIN的患者进行。患者人口统计数据，收集手术数据和影像学信息.对于每个病人来说,使用蒙特卡罗PCXMC2.0模拟软件计算器官剂量和有效剂量。电离辐射生物效应VII（BEIRVII）2期报告中提出的癌症风险模型用于评估暴露诱导的癌症死亡（REID）值的风险。
结果：对于所有患者，最高的器官剂量被送到性腺。股骨和胫骨骨折ESIN的平均有效剂量为0.026±0.015mSv和1.3E-04±1E-04mSv，分别。男性的平均REID为百万分之一，而女性的平均REID为百万分之0.19。年轻男性的REID值要高得多。有效剂量与年龄显著相关,性别,和照射时间。
结论：在目前的实践中，在长骨骨折的ESIN治疗中，与透视机的使用相关的有效剂量和癌症风险较低。
结论：这一结果将有助于提高外科医生对辐射风险的认识，并鼓励他们采取措施，使辐射剂量和暴露时间尽可能低。
