Insertion of K-wires by hammer generates less heat: A study of drilling and hammering K-wires into bone

Žegunis, Vidmantas; Tikuisis, Robertas

doi:10.3109/17453679308993700

Cited by 13 publications

(17 citation statements)

References 10 publications

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“…This is in agreement with previous in vitro results of Wassenaar et al [24] and Zegunis et al [26]. It must be stated, however, that drilling time in the present experiment was relatively long compared to that of studies mentioned above.…”

Section: Discussionsupporting

confidence: 94%

“…This was unexpected because collagen of human and rabbit bone tissue are comparable [2,22] and other studies comparing K-wires with different osteosynthesis material also using the rabbit as a model never mentioned cracks or fractures [3,5,19]. An exception was the paper of Zegunis et al In this report, it was advised to lower the power produced by the pneumatic hammer in fragile and small bones to prevent fractures [26]. Our results confirm this advice by demonstrating that a low weight of 1.0 kg is still sufficient to cause cracks.…”

Section: Discussionmentioning

confidence: 92%

“…This percutaneous technique is considered as a simple and quick method that reduces postsurgical swelling and stiffness compared to open reduction and internal fixation [17]. The currently used drill technique, however, can cause human phalanges to reach temperatures of up to 141°C, which can result in serious heat-related complications [1,2,18,26]. If temperatures exceed 47°C for 1 min, osteonecrosis occurs [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Hammering has some advantages compared to drilling in vitro, including lower temperatures, better initial fixation, and shorter insertion time [24,26]. However, to our knowledge, there are no reports of biomechanical aspects of hammered K-wires in vivo.…”

Section: Introductionmentioning

confidence: 99%

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In vivo biomechanical comparison of hammering vs drilling of Kirschner wires; a pilot study in rabbits

et al. 2007

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Heat generation due to drilling Kirschner wires (Kwires) into bone can lead to serious complications. Hammering K-wires could be an alternative insertion method because it generates less heat and results in better fixation and a shorter insertion time. There is, however, no in vivo information about insertion time and biomechanics of hammered K-wires. Insertion time was measured when drilling or hammering Kwires into femurs and tibias of 16 rabbits. Four K-wires inserted in one hind limb were used to measure extraction and torque forces directly after insertion (T = 0) and four K-wires inserted in the contralateral hind limb were used for the same measurements 4 weeks after insertion (T = 4). The insertion time for hammering was significantly shorter compared to drilling. Extraction and torque properties measured at T = 0 and T = 4 were equal for both techniques. Hammering, however, resulted in more cracks. Based on these results neither of these methods can be identified as a superior technique to insert K-wires in fragile bones.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In vivo biomechanical comparison of hammering vs drilling of Kirschner wires; a pilot study in rabbits

et al. 2007

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“…Furthermore, Jakopec et al [104] brought in the pneumatic tourniquet in their study on a hands-on robotic framework based total knee replacement involving of several individual robots. Another different, attempt by Zegunis et al [105] compared the thermal effects in a pneumatic hammer drilling and conventional drill-bit based drilling by embedding k-type thermocouples in the bone. The observations revealed that under similar conditions, the hammering generated an average maximum temperature of 31…”

Section: Pneumatic and Hydraulic Machiningmentioning

confidence: 99%

Non-conventional and Hybrid Methods of Bone Machining

Dahotre

Joshi

2016

Machining of Bone and Hard Tissues

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Having explored the basics of important fundamental contact (mechanical) and noncontact (thermal) operations involved in machining of the bones, the discussion will proceed towards some of the non-conventional techniques. These techniques have evolved as a result of research works on interaction of bones with various energy sources such as photon/electron beam and mechanical vibrations. Hybrids of fundamentals operations of machining have also been taken into account. Laser, microwave, and ion-beam based methods have been discussed under beam based techniques. Ultrasonic machining which has been extensively explored for bone application has been dealt in a separate section. Pneumatic and hydraulic machining have been taken into account under the section on hybrid machining. These nonconventional/hybrid techniques are not as popular as conventional ones but hold a huge potential for the future. High Energy Beam Based TechniquesThe high energy beam based methods employ some sort of radiation as the means of energy source for removal of the bone material. These techniques have mostly been employed previously in case of the structural materials. Unlike conventional mechanical contact methods employing physical tools which result in generation of heat as the secondary effect, beam based techniques employ heat as the primary means of tooling. The heat is generated by means of various electromagnetic waves within the electromagnetic spectrum such as ultraviolet, microwave, and infrared with various combinations for ranges of energy and wavelength ( Fig. 3.1). As the combinations dictate the extent and mode of interaction of the energy source with the workpiece, any machining operation can be carried out with careful process control. Most common methods explored in this category include laser, ion-beam, and microwave machining which are discussed in detail in the following subsections. Laser MachiningLasers (Light Amplification by Stimulated Emission of Radiation) have been used as a means of machining for quite some time now. Theoretically any wavelength within the electromagnetic spectrum can be made into a laser source. Principally, a lasing medium is excited using a energy source such as inert gas flash lamp. The input of energy (Fig. 3.2a) transfers the electrons within the atoms of the medium to higher energy state, technically termed as population inversion. On the other hand, the random absorption of energy gives rise to spontaneous emission (Fig. 3.2b). In case of population inversion, these electrons jump to lower energy state at the same time emitting photons of the same energy corresponding to difference between ground and excited state (Fig. 3.2c). A set of two mirrors, some times called resonators, one totally and the other partially reflecting, generates the chain reaction giving rise to highly concentrated beam coming out of the partially reflecting mirror (Fig. 3.3). This beam is monochromatic, coherent, and highly collimated in nature and can be employed for various applications depending on the wavele...

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Treatment Concepts

2000

Skeletal Injury in the Child

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Insertion of K-wires by hammer generates less heat: A study of drilling and hammering K-wires into bone

Cited by 13 publications

References 10 publications

In vivo biomechanical comparison of hammering vs drilling of Kirschner wires; a pilot study in rabbits

In vivo biomechanical comparison of hammering vs drilling of Kirschner wires; a pilot study in rabbits

Non-conventional and Hybrid Methods of Bone Machining

Treatment Concepts

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