ارزیابی دز دریافتی بیماران تحت عمل های ارتوپدی با استفاده از فانتوم محاسباتی شبه انسانی و اندازه گیری های تجربی

Introduction: The use of ionizing radiation in diagnosis and treatment of diseases has become inevitable in most medical branches. One of the important sections in medicine is orthopedic surgery room, which also serves to operate many of bone injuries. The aim of this study was to measure the delivered doses to the patients undergoing orthopedic surgeries in common and high usage radiographic imaging techniques. Methods and Materials: In this study, delivered doses to 81 patients (58% male, 42% female) underwent four orthopedic radiography examinations including intramedullary nailing (IMN), intertrochanteric/peritrochanteric (IP), Dynamic Hip Screw(DHS) and Dynamic Cannula Screw(DCS) was estimated at a general hospital in Tehran, using indirect measurements and Monte Carlo simulations base on the peak kilo-voltage, electrical current (mA), time of the irradiation (sec), exposure angle, imaging region and size of the patients. Results: The average effective dose measured for IMN, IP, DHS and DCS examinations were estimated equal to 0/95, 1/31, 2/22, 0/95 (mSv ) respectively. The mentioned values were calculated just for one radiography procedure, although in real orthopedic surgical operations, the number of radiographies can differ from 5 to 20 with respect to the physician and radiation technician proficiency, method of the operation and type of the injuries. So the delivered effective dose to patients can have much higher values than mentioned above.   Discussion and Conclusion: The patients delivered dose had great variations between different patients and techniques, because it depends on many factors including the type of medical imaging systems, examination complexity, region of imaging, physician and technician skills and patient weight. It is possible to reduce patients’ effective dose by using small field of views, appropriate potential difference, time of irradiation and electrical current. There is still a need for personnel training and national guidance for optimizing the patients’ doses.