Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
J Surg Orthop Adv. 2022 Winter;31(4):233-236.
This study's objective was to identify a difference in maximum temperature change during forward versus oscillating drilling of cadaveric bone. Paired femurs were dissected from the soft tissue of five cadavers. Each cadaver had one femur assigned to forward and the other to oscillation. The first drill hole was 2.5 cm distal to the lesser trochanter and the remaining 10 holes were evenly spaced 2 cm apart. A System 7 drill and 3.5 mm drill bit were attached to an Instron 5500R to provide a progressive force of 50 Newtons per minute for each drill hole. A thermal camera recorded each drilling. A new drill bit was used for each femur. Fifty bicortical drillings were analyzed in each group. The average time to complete forward drilling (45.0 seconds) was shorter compared to oscillation (55.5 s, p < 0.001). The average force required for forward drilling (27.7 N) was lower than for oscillation (44.3N, p < 0.001). The maximum change in temperature during the drilling process was similar (oscillating 100.2° F vs. forward 100.7° F, p = 0.871). The maximum change in temperature at the near cortex was lower for oscillation (78.1°F) compared to forward drilling (89.1°F, p = 0.011), while the maximum change at the far cortex was lower for forward drilling (89.3°F) compared to oscillation (95.8°F, p = 0.115) but not significantly. Overall, there is no difference in the thermal output between techniques. Oscillation may be beneficial in proximity to vital structures or to navigate narrow bony corridors, but it requires additional time and force. (Journal of Surgical Orthopaedic Advances 31(4):233-236, 2022).
本研究旨在确定尸体骨前向与振荡钻孔过程中最大温度变化的差异。从五个尸体的软组织中解剖出配对的股骨。每个尸体的一根股骨被分配到前向组，另一根分配到振荡组。第一个钻孔位于小转子远端 2.5 厘米处，其余 10 个孔均匀间隔 2 厘米。将 System 7 钻头和 3.5 毫米钻头连接到 Instron 5500R 上，为每个钻头孔提供每分钟 50 牛顿的渐进力。一个热像仪记录了每个钻孔过程。每个股骨都使用新的钻头。在每组中分析了 50 个双皮质钻孔。前向钻孔（45.0 秒）的平均完成时间比振荡（55.5 秒）短（p<0.001）。前向钻孔所需的平均力（27.7N）低于振荡（44.3N，p<0.001）。钻孔过程中最大温度变化相似（振荡 100.2°F 对前向 100.7°F，p=0.871）。近皮质的最大温度变化在振荡时较低（78.1°F），而在前向钻孔时较高（89.1°F，p=0.011），而远皮质的最大温度变化在前向钻孔时较低（89.3°F），而在振荡时较高（95.8°F，p=0.115），但无显著差异。总体而言，两种技术之间的热输出没有差异。在接近重要结构或在狭窄的骨道导航时，振荡可能是有益的，但需要额外的时间和力。（《手术矫形进展杂志》31(4):233-236，2022 年）。
