Since the 1980’s C-arm fluoroscopy has been an integral part of orthopaedic trauma surgery. The advancement in C-arm technology has resulted in different generations of C-arms co-existing in the operating rooms. The purpose of this study was to compare the radiation scatter patterns of different generation C-arms. Three generation of C-arms were tested: GE OEC 9800 Plus (1999/2000), Siemens Arcadis Orbic 3D (2004), Philips BV Pulsera 2.3 (2008). Radiation scatter was measured using six real-time dosimetry badges set up on either side of the surgical table (Mizuho OSI, flat-top). Distance of C-arm was normalized at 20 in. and 10 in. from Image Intensifier. Each device was set to the automatic brightness control (ABC) setting. A phantom limb was irradiated for 120 s and radiation scatter was summed for both AP and lateral positions. At their typical operating room settings there was a reduction in radiation scatter using the newer generation C-arms. Results for total radiation, normalized to Philips, are as follows: Philips 1 (100%), GE 2.4 (240%), and Siemens 1.4 (140%). Newer generation C-arms can be expected to generate lower radiation scatter. Special care should be taken to attempt a lower dose setting, especially when utilizing older generation C-arms to minimize radiation scatter to practitioner.

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