Pangnguriseng Utomo Andi, Imade Shinji, Furuya Satoshi, Nakazawa Koichiro, Shiraishi Kazuma, Sato Masaya, Kawamura Toshihiko, Uchio Yuji
Department of Orthopaedic Surgery, Shimane University Faculty of Medicine, Shimane, Japan; Department of Orthopaedic, Faculty of Medicine, Universitas Muslim Indonesia, Sulawesi Selatan, Indonesia.
Department of Orthopaedic Surgery, Shimane University Faculty of Medicine, Shimane, Japan.
J Orthop Sci. 2025 Mar;30(2):405-412. doi: 10.1016/j.jos.2024.04.001. Epub 2024 Apr 17.
When a pilot hole is made prior to a screw's insertion into bone, the same drill bit is used irrespective of the bone quality. However, osteoporotic bone is fragile and this may affect the hole diameter, which is of particular concern in cancellous bone. In this study, the relationship between bone density and drill-hole diameter was investigated assuming a pre-drilling process in screw-only osteosynthesis in the metaphysis and epiphysis.
Two types of drill bit (triple-flute [T] and quadruple-flute [Q]) with different shapes and diameters were prepared: type T bits with 3.5 mm and 4.4 mm diameters, and type Q bits with 3.5 mm and 4.2 mm diameters. Drilling was performed manually in simulated bones with four densities: 5, 10, 15, and 20 pounds per cubic foot. We measured the hole diameters with a coordinate measuring machine and analyzed the relationship between the drill-hole diameters and the densities of the simulated bones. We then compared the screw pull-out strength between the two 3.5-diameter drill bits.
In all cases, the diameters of the drill holes were larger than those of the drill bits. The relationship between the drill-hole diameters and the bone densities was a negative linear correlation. Enlarging the hole diameter decreased the screw pull-out strength.
For cannulated drill bits of 3.5, 4.2 and 4.4 mm diameter, the diameter of the drill hole in cancellous bone obtained by the manual drilling technique tends to be larger in low-density (e.g., osteoporotic) compared to high-density (e.g., healthy) bone.
在将螺钉插入骨骼之前制作导向孔时，无论骨质如何，都使用相同的钻头。然而，骨质疏松性骨较为脆弱，这可能会影响钻孔直径，在松质骨中这一点尤为值得关注。在本研究中，假设在干骺端和骨骺端单纯螺钉内固定的预钻孔过程，研究了骨密度与钻孔直径之间的关系。
准备了两种形状和直径不同的钻头（三刃 [T] 和四刃 [Q]）：直径为 3.5 毫米和 4.4 毫米的 T 型钻头，以及直径为 3.5 毫米和 4.2 毫米的 Q 型钻头。在四种密度的模拟骨中进行手动钻孔：每立方英尺 5、10、15 和 20 磅。我们使用坐标测量机测量钻孔直径，并分析钻孔直径与模拟骨密度之间的关系。然后比较了两种 3.5 毫米直径钻头之间的螺钉拔出强度。
在所有情况下，钻孔直径均大于钻头直径。钻孔直径与骨密度之间呈负线性相关。增大钻孔直径会降低螺钉拔出强度。
对于直径为 3.5、4.2 和 4.4 毫米的空心钻头，通过手动钻孔技术在松质骨中获得的钻孔直径，在低密度（如骨质疏松性）骨中往往比在高密度（如健康）骨中更大。
