Palmisano Andrew C, Tai Bruce L, Belmont Barry, Irwin Todd A, Shih Albert, Holmes James R
Departments of *Orthopaedic Surgery; †Mechanical Engineering, and ‡Biomedical Engineering, University of Michigan, Ann Arbor, MI.
J Orthop Trauma. 2015 May;29(5):e188-93. doi: 10.1097/BOT.0000000000000240.
Significant data exist regarding heat production of twist drills; however, there are little data regarding cannulated drills or Kirschner (K) wires. This study compared the heat produced during bone drilling with twist drills, K wires, and a cannulated drill. It was hypothesized that drilling temperature would increase with tool sizes used in orthopaedic surgery; with twist drills producing the least amount of heat followed by cannulated drills and K wires.
Twist drills (2.0, 2.5, and 3.5 mm), K wires (1.25, 1.6, and 2.0 mm), and a cannulated drill (2.7 mm) were driven into warmed human cadaveric tibia by a battery-powered hand drill. The drill was secured on a servo-controlled linear actuator to provide a constant advancing speed (1 mm/s) during drilling. Two thermocouples were embedded 2 mm from the surface at 0.5 and 1.5 mm from the drill hole margin. Eight tests were performed for each tool.
Twist drills exhibited a positive trend between size and heat production. The size effect was less significant with K wires. K wires resulted in significantly (P = 0.008 at 0.5 mm) higher peak temperatures than twist drills of the same size. A 2.7-mm cannulated drill produced more than double the temperature rise of a 2.5-mm twist drill.
Twist drills produced the smallest temperature rise among all bit types. Thermal effects should not be a reason for choosing K-wire size. The cannulated drill showed significantly higher temperatures when compared with standard drills, reaching maximal temperatures comparable with K wires.
关于麻花钻的产热已有大量数据；然而，关于空心钻或克氏针（K 针）的相关数据却很少。本研究比较了麻花钻、K 针和空心钻在骨钻孔过程中产生的热量。研究假设是，骨科手术中使用的工具尺寸越大，钻孔温度越高；麻花钻产生的热量最少，其次是空心钻和 K 针。
使用电池驱动的手持钻将麻花钻（2.0、2.5 和 3.5 毫米）、K 针（1.25、1.6 和 2.0 毫米）和空心钻（2.7 毫米）钻入温热的人体尸体胫骨。将钻头固定在伺服控制的线性致动器上，以便在钻孔过程中提供恒定的推进速度（1 毫米/秒）。在距钻孔边缘 0.5 和 1.5 毫米处，将两个热电偶埋入距表面 2 毫米处。每种工具进行 8 次测试。
麻花钻的尺寸与产热之间呈现正相关趋势。K 针的尺寸效应不太显著。K 针导致的峰值温度显著高于相同尺寸的麻花钻（在 0.5 毫米处 P = 0.008）。2.7 毫米的空心钻产生的温度升高是 2.5 毫米麻花钻的两倍多。
在所有钻头类型中，麻花钻产生的温度升高最小。热效应不应成为选择 K 针尺寸的理由。与标准钻头相比，空心钻显示出显著更高的温度，达到与 K 针相当的最高温度。
