Orthopaedic Bone Drills – Can They Be Improved?

Abstract

We studied the various drill bits available for engineering purposes, and compared them with standard orthopaedic drill bits, using continuous temperature recording at 0.5 mm, 1.0 mm and 1.5 mm from the edge of a 2.5 mm hole as it was drilled in fresh cadaver human tibia.We found that some commercially available drill bits performed better than their orthopaedic equivalents, producing significantly less thermal injury to the surrounding bone and halving the force required for cortical penetration. Our work suggests that the optimal bit for orthopaedic purposes should have a split point and a quick helix. Theoretical knowledge of cutting technology predicts that the addition of a parabolic flute will further reduce thermal damage. Further work is being done on other drill sizes used in orthopaedic practice and on new custom-designed bits.

Experimental investigations of forces and torque in conventional and ultrasonically-assisted drilling of cortical bone

“…Recent technological improvements, aimed at achieveing minimal invasion in bone drilling, are mainly focused on the design of drills [4,5]. Another approach is to use a robot-assisted surgery system, where a sensitive force feed-back system controls the tool action.…”

“Death by a thread” – Peritonitis due to visceral perforation by a guide wire, during proximal femur osteosynthesis with DHS: A fatal case and legal implications

“…Mishra et al proposed some guiding steps to avoid these complications: inspection of the lumen of all drills, avoidance of abusive guide wire reutilization, the use of cannulated instruments and always use fluoroscopic image control. Every complication should be documented in the clinical report [10,13,17]. Post-operative abdominal pain after hip, pelvic or spinal surgery should be carefully analyzed.…”

The design and function of surgical drills and K-wires

“…At surgery bone debris is mixed with blood and marrow fat and in this wet state it flows differently and tends to clog slow helix flutes; in this situation quick helix flutes are more suitable. 1 The periosteum has been shown to obstruct the flow of chips through the drill flutes. 5,8 The chisel edge catches the periosteum and eventually carries it to the flutes where it obstructs chip flow.…”

“…The problems of flute blockage were reduced as was walking on the bone surface. Natali et al 1 compared various commercial drill bits with surgical drills in the drilling of bone. He also showed the superiority of the 1181 point angle and split point clearance angle design.…”