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Veterinary surgery : VS2026; 55(7); 1212-1222; doi: 10.1111/vsu.70126

Radiation exposure to equine surgeons during simulated digital radiography and fluoroscopy-guided fracture fixation of the distal limb.

Abstract: Despite known occupational radiation risks, data on exposure during digital radiography (DR) or fluoroscopy-guided equine fracture repair are lacking. This study quantified radiation doses to a model surgeon's hand, lenses, thyroid, and gonads, and assessed protective effects of radiation-reducing surgical gloves and attenuating ointment. Methods: Comparative, controlled, simulation-based study. Unassigned: Anthropomorphic model. Methods: Distal limb fracture fixation was simulated using a model with dosimeters at the region of the lenses, thyroid, gonads, drill-holding hand, and under a lead apron (fetal dose). Radiation was measured over 10 DR or 10 single-image fluoroscopy exposures, then repeated using radiation-reducing surgical gloves or ointment. Results: All radiation doses were below occupational limits. Dosimeters placed at the level of the gonads (outside the gown) received the highest mean dose (DR: 6.87 ± 0.40 μSv; fluoroscopy: 0.98 ± 0.28 μSv), followed by thyroid (outside the gown) (DR: 2.60 ± 0.52 μSv; fluoroscopy: 0.48 ± 0.08 μSv), hand (DR: 2.02 ± 0.54 μSv; fluoroscopy: 0.32 ± 0.06 μSv) and lenses (DR: 1.25 ± 0.28 μSv; fluoroscopy: 0.23 ± 0.07 μSv). The lowest exposure was measured underneath the gown (fetal dose) (DR: 0.01 ± 0.01 μSv; fluoroscopy: 0.01 ± 0.01 μSv). DR exposure exceeded fluoroscopy at all sites (p < .001). Radiation-reducing surgical gloves significantly lowered hand dose (p < .001), whereas ointment had no effect (p = .54). Off-beam hand exposure from 10 images was approximately one-millionth of the annual dose limit. Conclusions: Image-guided equine distal limb fracture fixation results in minimal hand radiation exposure, relative to other regions of the body, with DR producing higher doses than single-image fluoroscopy. Radiation-reducing surgical gloves significantly lower hand exposure during DR procedures. Conclusions: Radiation-reducing surgical gloves offer additional protection and are recommended during image-guided surgery. Whenever feasible, pulsed fluoroscopy should be preferred over DR.
© 2026 American College of Veterinary Surgeons.
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Publication Date: 2026-06-26 PubMed ID: 42359489DOI: 10.1111/vsu.70126Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Radiation exposure to equine surgeons during image-guided fracture fixation of the distal limb is low and well below occupational safety limits, with digital radiography producing higher doses than single-image fluoroscopy. Using radiation-reducing surgical gloves significantly decreases hand exposure during these procedures.

Study Purpose and Background

  • The research aimed to quantify radiation exposure to equine surgeons performing distal limb fracture fixation using digital radiography (DR) or single-image fluoroscopy guidance.
  • Despite acknowledged occupational radiation risks in veterinary surgery, data specifically on exposure during these imaging techniques in equine fracture repair were previously unavailable.
  • The study also assessed the protective benefits of radiation-attenuating surgical gloves and an ointment designed to reduce radiation dose.

Methods

  • A controlled, simulation-based design was used with an anthropomorphic model mimicking the surgeon’s body.
  • Dosimeters were placed at key anatomical sites of radiation concern: lenses (eyes), thyroid gland, gonads, the hand holding the drill, and beneath a lead apron representing fetal exposure.
  • Two types of imaging procedures were tested: 10 exposures of digital radiography and 10 exposures of single-image fluoroscopy.
  • The experiment was repeated twice more, once with radiation-reducing surgical gloves and once using a radiation-attenuating ointment on the hand.

Key Results

  • All measured radiation doses were substantially below the occupational exposure limits broadly accepted for healthcare workers.
  • The highest radiation dose was recorded at the gonads (outside lead protection), followed by the thyroid, hand, and lenses, indicating these areas received varying but relatively low levels of radiation.
  • Radiation measurements (mean ± SD in microsieverts, µSv) for digital radiography versus fluoroscopy were as follows:
    • Gonads: 6.87 ± 0.40 µSv (DR) vs. 0.98 ± 0.28 µSv (fluoroscopy)
    • Thyroid: 2.60 ± 0.52 µSv (DR) vs. 0.48 ± 0.08 µSv (fluoroscopy)
    • Hand: 2.02 ± 0.54 µSv (DR) vs. 0.32 ± 0.06 µSv (fluoroscopy)
    • Lenses: 1.25 ± 0.28 µSv (DR) vs. 0.23 ± 0.07 µSv (fluoroscopy)
    • Fetal dose under lead gown: 0.01 ± 0.01 µSv for both modalities
  • Digital radiography consistently exposed all sites to higher radiation doses than single-image fluoroscopy, with statistically significant differences (p < 0.001).
  • Using radiation-reducing surgical gloves significantly reduced hand dose during digital radiography exposures (p < 0.001), whereas applying the attenuating ointment showed no significant reduction (p = 0.54).
  • Notably, hand exposure off the imaging beam from 10 exposures was about one-millionth of the annual dose limit for radiation workers, indicating very low risk.

Conclusions and Recommendations

  • Radiation exposure to equine surgeons during image-guided distal limb fracture fixation is minimal, particularly to the hands compared with other body regions.
  • Digital radiography produces higher radiation doses than single-image fluoroscopy at all measured locations.
  • Wearing radiation-reducing surgical gloves provides meaningful protection for the surgeon’s hands and is recommended during DR-guided procedures.
  • Whenever possible, pulsed fluoroscopy should be preferred over digital radiography to minimize radiation exposure.
  • Standard radiation protection measures such as lead aprons effectively reduce exposure to internal organs and fetal dose remains negligible.

Implications

  • The study provides important occupational safety data specifically for equine surgeons, supporting informed decisions regarding radiation protection in veterinary orthopedic surgery.
  • Adoption of radiation-reducing gloves and optimization of imaging modalities can further lower surgeons’ radiation risks without compromising procedural success.
  • These findings encourage routine monitoring of radiation exposure and reinforcement of protective practices in equine surgical settings.

Cite This Article

APA
Gaida JL, Stieger-Vanegas SM, Lischer CJ, Duesterdieck-Zellmer KF, Huber MJ, Kamm JL. (2026). Radiation exposure to equine surgeons during simulated digital radiography and fluoroscopy-guided fracture fixation of the distal limb. Vet Surg, 55(7), 1212-1222. https://doi.org/10.1111/vsu.70126

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 55
Issue: 7
Pages: 1212-1222

Researcher Affiliations

Gaida, Julia L
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.
  • Equine Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Stieger-Vanegas, Susanne M
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.
Lischer, Christoph J
  • Equine Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Duesterdieck-Zellmer, Katja F
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.
Huber, Michael J
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.
Kamm, J Lacy
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.

MeSH Terms

  • Animals
  • Fluoroscopy / veterinary
  • Horses / injuries
  • Horses / surgery
  • Radiation Exposure
  • Occupational Exposure
  • Fractures, Bone / veterinary
  • Fractures, Bone / surgery
  • Fractures, Bone / diagnostic imaging
  • Radiation Dosage
  • Thyroid Gland / radiation effects
  • Fracture Fixation / veterinary
  • Fracture Fixation / methods
  • Radiographic Image Enhancement
  • Forelimb
  • Surgeons

Grant Funding

  • 6748 / American College of Veterinary Surgeons Foundation
  • Carlson College of Veterinary Medicine, Oregon State University

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