Mini C‐arm: faster, cheaper, safer?

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.