Augustin Goran, Davila Slavko, Mihoci Kristijan, Udiljak Toma, Vedrina Denis Stjepan, Antabak Anko
Department of Surgery, University Hospital Center Zagreb, Kispatićeva 12, 10000 Zagreb, Croatia.
Arch Orthop Trauma Surg. 2008 Jan;128(1):71-7. doi: 10.1007/s00402-007-0427-3. Epub 2007 Aug 30.
During the drilling of the bone, the temperature could increase above 47 degrees C and cause irreversible osteonecrosis. The result is weakened contact of implants with bone and possible loss of rigid fixation. The aim of this study was to find an optimal condition where the increase in bone temperature during bone drilling process would be minimal.
Influence of different drill parameters was evaluated on the increase of bone temperature. Drill diameters were 2.5, 3.2 and 4.5 mm; drill speed 188, 462, 1,140 and 1,820 rpm; feed-rate 24, 56, 84 and 196 mm/min; drill point angle 80 degrees , 100 degrees and 120 degrees and external irrigation with water of 26 degrees C.
Combinations of drill speed and drill diameter with the use of external irrigation produced temperatures far below critical. Without external irrigation, temperature values for the same combination of parameters ranged 31.4-55.5 degrees C. Temperatures above critical were recorded using 4.5 mm drill with higher drill speeds (1,140 and 1,820 rpm). There was no statistical significance of different drill point angles on the increase or decrease of bone temperature. The higher the feed-rate the lower the increase of bone temperature.
The external irrigation is the most important cooling factor. With all combinations of parameters used, external irrigation maintained the bone temperature below 47 degrees C. The increase in drill diameter and drill speed caused increase in bone temperature. The changes in drill point angle did not show significant influence in the increase of the bone temperature. With the increase in feed-rate, increase in bone temperature is lower.
在钻骨过程中，温度可能会升高至47摄氏度以上并导致不可逆的骨坏死。结果是植入物与骨的接触减弱以及可能失去牢固固定。本研究的目的是找到一种最佳条件，使钻骨过程中骨温度的升高最小化。
评估了不同钻头参数对骨温度升高的影响。钻头直径为2.5、3.2和4.5毫米；钻速为188、462、1140和1820转/分钟；进给速度为24、56、84和196毫米/分钟；钻尖角为80度、100度和120度，并使用26摄氏度的水进行外部冲洗。
使用外部冲洗时，钻头速度和钻头直径的组合产生的温度远低于临界温度。不进行外部冲洗时，相同参数组合的温度值在31.4至55.5摄氏度之间。使用4.5毫米钻头且钻速较高（1140和1820转/分钟）时记录到高于临界温度的情况。不同钻尖角对骨温度的升高或降低没有统计学意义。进给速度越高，骨温度的升高越低。
外部冲洗是最重要的冷却因素。在所有使用的参数组合下，外部冲洗使骨温度保持在47摄氏度以下。钻头直径和钻速的增加导致骨温度升高。钻尖角的变化对骨温度的升高没有显著影响。随着进给速度的增加，骨温度的升高较低。
