Article

Bone drilling is a common step in operative fracture treatment and
reconstructive surgery. During drilling elevated bone temperature is generated.
Temperatures above 47 degrees C cause thermal osteonecrosis which contributes to
screw loosening and subsequently implant failures and refractures. METHODS: The
current literature on bone drilling and thermal osteonecrosis is reviewed. The
methodologies involved in the experimental and clinical studies are described and
compared. FINDINGS: Areas which require further investigation are highlighted and
the potential use of more precise experimental setup and future technologies are
addressed. INTERPRETATION: Important drill and drilling parameters that could
cause increase in bone temperature and hence thermal osteonecrosis are reviewed
and discussed: drilling speed, drill feed rate, cooling, drill diameter, drill
point angle, drill material and wearing, drilling depth, pre-drilling, drill
geometry and bone cortical thickness. Experimental methods of temperature
measurement during bone drilling are defined and thermal osteonecrosis is
discussed with its pathophysiology, significance in bone surgery and methods for
its minimization.
CI - Copyright (c) 2011 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS