ArticleThe Iowa orthopaedic journal2025
Fluoroscopy in Hip Fracture Surgery: An Analysis of Resident Utilization.
Article in The Iowa orthopaedic journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Background: Fluoroscopy is a critical tool in operative fracture reduction and fixation that residents begin using early in their careers. Judiciously managing fluoroscopy use in a procedure should be a focus in training. Total radiation dose is routinely recorded, but the distribution of fluoroscopy use throughout a procedure has not been well researched. This study aimed to determine how much fluoroscopy residents use in cephalomedullary nail (CMN) fixation of hip fractures. The study further sought to identify distinct tasks in the procedure that require more or less fluoroscopy. Methods: Eighty-five CMN cases for which complete sets of fluoroscopic images were available were studied. Nine distinct tasks were analyzed in each case: set up, reduction, entry point navigation, reaming, nail placement, femoral head navigation, proximal screw placement, distal screw(s) placement, and final checks. Image use and time elapsed during tasks was recorded and attributed to the most-junior resident, who would typically be most hands-on at our institution for this procedure. Results: Residents completed CMN placement in an average of 66.2 minutes (± 31.7) using an average of 185 images (± 113). Entry point navigation required the most time, 14 ± 10.8 minutes, and images, 49 ± 42. This was a significantly greater use of time (t(121) = 4.96, p < 0.001) and images (t(133) = 3.45, p < 0.001) than other tasks. Conclusion: These data highlight the sheer volume of fluoroscopy used by residents in a common procedure. The sub-task analysis indicates that the freehand entry point navigation requires the greatest use of fluoroscopy and time, suggesting residents may benefit from additional laboratory-based training on this portion of the procedure. Clinical Relevance: Orthopedic surgeons utilize fluoroscopy in a wide array of procedures. These findings emphasize the need to be intentional in the use of intra-operative fluoroscopy over a decades long career to prevent its potentially harmful effects. These results can also be used to improve education by creating objective metrics to evaluate resident fluoroscopy use and provide feedback.
Indexed as
Identifiers
40606698PMC12212306What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.