Pandey Rupesh Kumar, Panda S S
PhD Student, Indian Institute of Technology Patna, Department of Mechanical Engineering, Patna 800013, Bihar, India.
Assistant Professor, Indian Institute of Technology Patna, Department of Mechanical Engineering, Patna 800013, Bihar, India.
J Clin Orthop Trauma. 2013 Mar;4(1):15-30. doi: 10.1016/j.jcot.2013.01.002. Epub 2013 Jan 18.
BACKGROUND: Bone fracture treatment usually involves restoring of the fractured parts to their initial position and immobilizing them until the healing takes place. Drilling of bone is common to produce hole for screw insertion to fix the fractured parts for immobilization. Orthopaedic drilling during surgical process causes increase in the bone temperature and forces which can cause osteonecrosis reducing the stability and strength of the fixation. METHODS: A comprehensive review of all the relevant investigations carried on bone drilling is conducted. The experimental method used, results obtained and the conclusions made by the various researchers are described and compared. RESULT: Review suggests that the further improvement in the area of bone drilling is possible. The systematic review identified several consequential factors (drilling parameters and drill specifications) affecting bone drilling on which there no general agreement among investigators or are not adequately evaluated. These factors are highlighted and use of more advanced methods of drilling is accentuated. The use of more precise experimental set up which resembles the actual situation and the development of automated bone drilling system to minimize human error is addressed. CONCLUSION: In this review, an attempt has been made to systematically organize the research investigations conducted on bone drilling. Methods of treatment of bone fracture, studies on the determination of the threshold for thermal osteonecrosis, studies on the parameters influencing bone drilling and methods of the temperature measurement used are reviewed and the future work for the further improvement of bone drilling process is highlighted.
背景:骨折治疗通常包括将骨折部位恢复到初始位置并固定,直至愈合。在骨上钻孔以制造用于插入螺钉的孔来固定骨折部位以实现固定是常见的操作。手术过程中的骨科钻孔会导致骨温度和压力升高,这可能会引起骨坏死,从而降低固定的稳定性和强度。 方法:对所有关于骨钻孔的相关研究进行全面综述。描述并比较了所使用的实验方法、获得的结果以及不同研究人员得出的结论。 结果:综述表明,骨钻孔领域有可能进一步改进。系统综述确定了几个影响骨钻孔的相关因素(钻孔参数和钻头规格),研究人员对此尚未达成普遍共识,或者尚未得到充分评估。这些因素得到了突出强调,并着重指出了使用更先进的钻孔方法。文中还讨论了使用更接近实际情况的精确实验装置以及开发自动骨钻孔系统以尽量减少人为误差的问题。 结论:在本综述中,已尝试系统地整理关于骨钻孔的研究调查。回顾了骨折治疗方法、热骨坏死阈值测定研究、影响骨钻孔的参数研究以及所使用的温度测量方法,并强调了为进一步改进骨钻孔过程而开展的未来工作。
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