The Radiology Technologist's Handbook to Surgical Procedures

AnthonyC Anderson

• Editore: CRC Press
• Anno: 2017
• ISBN:
  9781351409339
• Edizione: 1
• Argomento: Jura
• Categoria: Forensik

In the past several years, the rapid development of sophisticated imaging modalities has made radiology the fastest growing specialty in medicine. It is important for the radiologic technologist to keep pace with technology's advancements. The influx of freestanding outpatient facilities and the demands of insurance companies, HMOs and third party reimbursement have brought about change. Medical facilities have begun to call upon nurses, surgical technicians, and other non-radiologic personnel to assist with patient positioning during surgical procedures requiring imaging-creating a need for a concise, how-to guide to performing surgical procedures. The Radiology Technologist's Handbook to Surgical Procedures provides a quick reference for using fluoroscopic and x-ray equipment during surgical procedures. This book includes detailed descriptions and photographs taken in actual clinical settings.By using this manual as a foundation, the radiologic technologist will be able to master many of the operating room x-ray procedures.

Part I:
Fluoroscopic Examinations

1. FEMORAL NAILING

(AP POSITION)

PATIENT POSITION: Patient will be in lateral position with affected femur up and slightly forward.

C-ARM POSITION: C-arm will enter facing patient. Rotate c-arm underneath the table to the ap projections. Ensure that c-arm is perpendicular to femur.

Notes: When moving from ap to lateral position, make sure not to bump instrumentation.

Position c-arm viewing cart at feet of patient with the doctor standing posterior to the patient.

Create distance and magnify image when creating round holes for distal locking screws.

During reaming, obtain true lateral of knee by tilting and rotating c-arm.

Position the c-arm to view reamers crossing fracture site.

Figure 1.1 C-arm in ap projection of hip.

Figure 1.2 C-arm image of ap hip with nail inserted.

2. FEMORAL NAILING

(LATERAL POSITION)

PATIENT POSITION: Patient will be in lateral position with affected femur up and slightly forward.

C-ARM POSITION: C-arm will enter facing patient. Rotate c-arm 10 to 15 degrees over top of patient. Tilt c-arm 5 to 10 degrees toward head of femur.

This view, called the Winquist View, is used to throw the unaffected femur out of view, to elongate the femoral neck for true lateral viewing of starting position and to check anterior and posterior position.

Notes: When moving from ap to lateral position, make sure not to bump instrumentation.

Position c-arm viewing cart at feet of patient.

Doctor will stand posterior to patient.

Figure 2.1 C-arm in lateral projection with Winquist tilt view.

Figure 2.2 C-arm image of lateral hip with starting auld in place.

Figure 2.3 The c-arm is in the Winquist view, which is best utilized to check anterior and posterior positions in relationship to the femoral shaft. The c-arm is rotated over the top and tilted to elongate the femur.

Figure 2.4 The c-arm in a true lateral view in relationship to femur position. The c-arm is tilted to align with the femur. This will give a better indication of fracture alignment and reamer size.

Figure 2.5 During distal targeting for femoral nail, raise the c-arm away from the knee to enlarge the hole and create working space. Use the magnify button on the c-arm if available.

Figure 2.6 Incorrect hole alignment. Note how hole is oblong.

Figure 2.7 Correct hole alignment. Note that hole is now rounded.

3. SUPRACONDYLAR FEMORAL NAIL

(AP VIEW)

PATIENT POSITION: Patient will be supine with the affected knee slightly bent on radiolucent table.

C-ARM POSITION: C-arm will enter perpendicular to patient and in the ap position.

Notes: Ensure underneath clearance allows for movement from the knee to the hip.

C-arm may have to be rotated over or backward to create a true ap view.

Tilt c-arm to open joint space of knee for starting point.

Figure 3.1 C-arm in ap projection of distal femur.

Figure 3.2 X-ray image of distal femur.

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