Heat accumulation during sequential cortical bone drilling.
Significant research exists regarding heat production during single-hole bone drilling. No published data exist regarding repetitive sequential drilling. This study elucidates the phenomenon of heat accumulation for sequential drilling with both Kirschner wires (K wires) and standard two-flute twist drills. It was hypothesized that cumulative heat would result in a higher temperature with each subsequent drill pass. Nine holes in a 3 × 3 array were drilled sequentially on moistened cadaveric tibia bone kept at body temperature (about 37 °C). Four thermocouples were placed at the center of four adjacent holes and 2 mm below the surface. A battery-driven hand drill guided by a servo-controlled motion system was used. Six samples were drilled with each tool (2.0 mm K wire and 2.0 and 2.5 mm standard drills). K wire drilling increased temperature from 5 °C at the first hole to 20 °C at holes 6 through 9. A similar trend was found in standard drills with less significant increments. The maximum temperatures of both tools increased from <0.5 °C to nearly 13 °C. The difference between drill sizes was found to be insignificant (P > 0.05). In conclusion, heat accumulated during sequential drilling, with size difference being insignificant. K wire produced more heat than its twist-drill counterparts. This study has demonstrated the heat accumulation phenomenon and its significant effect on temperature. Maximizing the drilling field and reducing the number of drill passes may decrease bone injury.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
Andrew C
AC
Palmisano
Department of Mechanical Engineering, Texas A&M University, College Station, Texas.
Bruce L
BL
Tai
Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan.
Barry
B
Belmont
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
Todd A
TA
Irwin
Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan.|Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan.
Albert
A
Shih
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
James R
JR
Holmes
D000328:Adult; D000368:Aged; D001864:Bone Wires; D001842:Bone and Bones / Q000601:surgery*; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D013314:Stress, Mechanical
Kirschner wire; bone drilling; cortical bone; heat accumulation; sequential drilling; thermal osteonecrosis