Leis Amber, Sharpe Frances, Hill J Ryan, Pannell William C, Wilson Melissa L, Ebramzadeh Edward, Stevanovic Milan
Department of Plastic and Reconstructive Surgery, University of California Irvine, Orange, California.
Department of Orthopedic Surgery, Keck School of Medicine at USC Los Angeles, California, Department of Orthopedic Surgery, Southern California Permanente Medical Group, Fontana, California.
Surg Technol Int. 2017 Jul 25;30:490-495.
Drill bit tip plunging past the far cortex places critical anatomical structures at risk. This study measured plunging past the far cortex based on level of training. The time required for screw placement when a depth gauge was used to measure bone tunnel depth was compared to the time required for screw placement when bone tunnel depth was measured in real time.
Thirty orthopedic surgery staff with 1-37 years of experience applied 10-hole plates to cadaveric limbs. Procedures were performed using two different drilling systems. Time and plunge depth were recorded.
Penetration past the far cortex ranged from an average of 11.9 mm in the novice group to an average of 6.1 mm in the experienced group (P <0.001). The time required to drill and place a screw decreased by an average of 14 seconds per screw when depth gauge use was eliminated.
Penetration past the far cortex occurred at all levels of training, but decreased with increased levels of experience. Real time measurement of bone tunnel length decreased total drilling time. The time saved with real time measurement decreased with increased level of experience.
钻头尖端穿过对侧皮质会使关键解剖结构处于危险之中。本研究根据训练水平测量了穿过对侧皮质的情况。将使用深度计测量骨隧道深度时拧入螺钉所需的时间与实时测量骨隧道深度时拧入螺钉所需的时间进行了比较。
30名具有1至37年经验的骨科手术人员在尸体肢体上应用10孔钢板。使用两种不同的钻孔系统进行操作。记录时间和穿透深度。
穿透对侧皮质的深度范围从新手组的平均11.9毫米到经验丰富组的平均6.1毫米（P<0.001）。当不使用深度计时，每个螺钉钻孔和拧入所需的时间平均减少14秒。
在所有训练水平上均会出现穿透对侧皮质的情况，但随着经验水平的提高而减少。实时测量骨隧道长度可减少总钻孔时间。实时测量节省的时间随着经验水平的提高而减少。
