Levels of exposure to radiation were recorded at sixty sites in fifteen
patients during intramedullary interlocking femoral nailing. Radiation film
dosimeters were placed at four gonadal sites on each subject. A standard
male-gonad cup or a pelvic drape of 0.5-millimeter-thick lead-equivalent
was put in place to shield the gonads. A second set of four dosimeters was
placed external to the shield to approximate unprotected exposure. The
total duration of the fluoroscopy averaged five minutes (range, thirty
seconds to fourteen minutes). The total exposure to radiation external to
the shield was 35 +/- 34 millirems at the male gonadal sites and 17 +/- 11
millirems at the female gonadal sites. With use of the gonadal shield,
exposure to radiation was not measurable in thirteen of the fifteen
patients. The differences between the exposures of the shielded and
unshielded sites to radiation were statistically significant (p less than
0.001). The highest level of gonadal exposure was found with the treatment
of proximal femoral fractures and with the use of statically locked nails.
Regardless of the conditions, and for all types of fractures and locations,
our results demonstrated that gonadal shielding is justified.