K 线重复使用和钻孔方式对骨热生成的影响。
Effect of K-wire Reuse and Drill Mode on Heat Generation in Bone.
机构信息
Edward Hines, Jr. VA Hospital, Hines, IL, USA.
Loyola University Chicago, Maywood, IL, USA.
出版信息
Hand (N Y). 2023 Mar;18(2):314-319. doi: 10.1177/15589447211003172. Epub 2021 May 14.
BACKGROUND
We examined the effect of Kirschner wire (K-wire) reuse and use of oscillating mode on heat generation within cortical bone.
METHODS
Two trocar-tipped K-wires were drilled through the diaphysis of each of 30 human metacarpals and phalanges: one K-wire was inserted in rotary mode and another in oscillating mode. Each wire was reused once. Thermocouples placed within the dorsal and volar bone adjacent to the K-wire drill path measured temperatures throughout each test.
RESULTS
Peak cortex temperatures were 25°C to 164°C. Rotary drilling achieves peak temperatures quicker (31 ± 78 seconds vs 44 ± 78 seconds, = .19) than oscillating drilling, but insertion time is also less, resulting in lower overall heat exposure. This effect is also seen when the K-wire is reused (34 ± 70 seconds vs 41 ± 85 seconds, = .4). The length of time that cortical bone was exposed to critical temperatures (47°C or more) was significantly higher when a wire was reused (36 ± 72 seconds vs 43 ± 82 seconds, = .008). Peak temperatures greater than 70°C (a temperature associated with instantaneous cell death) were observed on many occasions.
CONCLUSIONS
Overall heat exposure may be higher if a K-wire is reused or inserted in oscillating mode. In the absence of external cooling, K-wire insertion into cortical bone can easily expose bone to temperatures that exceed 70°C and may increase the risk of osteonecrosis.
背景
我们研究了克氏针（K-wire）重复使用和摆动模式对皮质骨产热的影响。
方法
在 30 个人类掌骨和指骨的骨干中分别用带套管的 K-wire 以旋转模式和摆动模式各钻一根 K-wire：一根 K-wire 重复使用一次。将热电偶放置在 K-wire 钻孔路径附近的背侧和掌侧骨内，以测量整个测试过程中的温度。
结果
皮质骨的最高温度为 25°C 至 164°C。旋转钻孔达到最高温度的速度更快（31 ± 78 秒比 44 ± 78 秒， =.19），但插入时间也更短，因此总体热暴露较低。当 K-wire 重复使用时，也会出现这种效果（34 ± 70 秒比 41 ± 85 秒， =.4）。皮质骨暴露于临界温度（47°C 或更高）的时间明显更长（36 ± 72 秒比 43 ± 82 秒， =.008）。在许多情况下，观察到超过 70°C 的峰值温度（与瞬时细胞死亡相关的温度）。
结论
如果 K-wire 重复使用或插入摆动模式，整体热暴露可能会更高。在没有外部冷却的情况下，K-wire 插入皮质骨很容易使骨暴露于超过 70°C 的温度，并可能增加骨坏死的风险。
Zotero 插件