Devdatta Suhas Neogi

Introduction The advent of minimally invasive surgery has increased the use of C-arm among orthopedic surgeons. Their views on the ergonomicity of radiation protection aprons and thyroid shields need elucidation. To investigate, we deliberated a question-based survey. The primary aim of the survey was to find out the percentage of those not using these devices, the prevalence of back pain, and its relationship with the type of radiation protection aprons. Materials and methods This was a cross-sectional survey. A five-section Google Forms survey (Google, Inc., Mountain View, CA) was filled out, and responses from 416 orthopedic surgeons were included. Analysis was carried out using Statistical Package for the Social Sciences (SPSS) version 14.0 (SPSS Inc., Chicago, IL). Results Of the total number of orthopedic surgeons, 36.8% felt that apart from radiation exposure, wearing a radiation protection apron was the biggest problem in C-arm usage. Furthermore, 20.4% wore thyroid shields the majority of the time. The 31-40 years age group was the most comfortable wearing these devices, wore them more often, and suffered more often from back pain (all p<0.01). Conclusion The study concluded that the majority of orthopedic surgeons were not comfortable with the current designs of radiation protection aprons and thyroid shields. Thyroid shields are worn less than aprons. Lead apron weight and thyroid shield ergonomicity were the number one reason for being bare-bodied. Among those who regularly wore aprons, a large proportion suffered from back pain.

We report a case of irreducible dorsal dislocation of all the lesser metatarsophalangeal joints of the foot following injury at sport. Plantar plate prevented reduction at all the joints, which necessitated an open reduction and stabilization with K-wire. This report highlights the necessity of prompt open reduction and reviews the mechanism of injury and complex anatomy at metatarsophalangeal joint. Levels of Evidence: Therapeutic, Level IV, Case study