Mini C‐arm: faster, cheaper, safer?. Issue 4 (30th November 2016)

• Record Type: Journal Article
• Authors: Gieroba, Tom J.; Williams, Nicole; Antoniou, Georgia; Cundy, Peter J.
• Is Part Of: ANZ journal of surgery. Volume 87:Issue 4(2017)
• Page Start: 282
• Page End: 286
• Publication Date: 2016-11-30
• Subjects: bone -- cast -- fluoroscopy -- forearm injury -- fracture -- manipulation -- orthopaedic -- surgical; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.13842
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract : Background: Mini C‐arm image intensifiers (IIs) are promoted to permit lower radiation dose than traditional IIs with a lower purchase price and without the need for a radiographer, saving time. In real‐world usage, radiation dose is not always lower. Methods: A retrospective review of prospectively collected data for 620 children undergoing forearm fracture reduction in theatre was undertaken. Imaging was performed with the Fluoroscan mini C‐arm or a comparison traditional II. Radiation dose and theatre time were recorded. Results: There was no significant difference in radiation dose as measured by dose‐area product (0.013 versus 0.014 Gy.cm 2, P = 0.22). We noted an inverse association between operator experience and radiation dose. The mini C‐arm allowed a shorter procedure time (26 versus 30 min, P < 0.001) and theatre time (13 versus 16 min, P < 0.001). Re‐displacement rates were similar (1.3 versus 2.2%). The Fluoroscan is AU$120 000 cheaper to purchase and AU$35 283 cheaper to run per year than the comparison II. Consultants had a 14% lower dose‐area product (0.012 versus 0.014 Gy.cm 2, P < 0.001) and 18% shorter screening time (8 versus 9.8 s, P < 0.001) than registrars. Conclusion: The Fluoroscan mini C‐arm II does not demonstrate a radiation saving during closed reductions of paediatric forearm fractures but allows shorter procedures and theatre time with similar re‐displacement rates. The purchase price is lower than a traditional II. We noted that operator experience reduces radiation dose.