Trauma Surgery

Archives of Orthopaedic and Trauma Surgery

, Volume 128, Issue 1, pp 71-77

First online:

Thermal osteonecrosis and bone drilling parameters revisited

  • Goran AugustinAffiliated withDepartment of Surgery, University Hospital Center Zagreb Email author 
  • , Slavko DavilaAffiliated withDepartment of Surgery, University Hospital Center Zagreb
  • , Kristijan MihociAffiliated withFaculty of Mechanical Engineering and Naval Architecture, Department of Technology, Chair of Machine Tools
  • , Toma UdiljakAffiliated withFaculty of Mechanical Engineering and Naval Architecture, Department of Technology, Chair of Machine Tools
  • , Denis Stjepan VedrinaAffiliated withFaculty of Chemical Engineering and Technology, Department of Measurement and Process Control
  • , Anko AntabakAffiliated withDepartment of Surgery, University Hospital Center Zagreb

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Abstract

Introduction

During the drilling of the bone, the temperature could increase above 47°C and cause irreversible osteonecrosis. The result is weakened contact of implants with bone and possible loss of rigid fixation. The aim of this study was to find an optimal condition where the increase in bone temperature during bone drilling process would be minimal.

Materials and methods

Influence of different drill parameters was evaluated on the increase of bone temperature. Drill diameters were 2.5, 3.2 and 4.5 mm; drill speed 188, 462, 1,140 and 1,820 rpm; feed-rate 24, 56, 84 and 196 mm/min; drill point angle 80°, 100° and 120° and external irrigation with water of 26°C.

Results

Combinations of drill speed and drill diameter with the use of external irrigation produced temperatures far below critical. Without external irrigation, temperature values for the same combination of parameters ranged 31.4–55.5°C. Temperatures above critical were recorded using 4.5 mm drill with higher drill speeds (1,140 and 1,820 rpm). There was no statistical significance of different drill point angles on the increase or decrease of bone temperature. The higher the feed-rate the lower the increase of bone temperature.

Conclusions

The external irrigation is the most important cooling factor. With all combinations of parameters used, external irrigation maintained the bone temperature below 47°C. The increase in drill diameter and drill speed caused increase in bone temperature. The changes in drill point angle did not show significant influence in the increase of the bone temperature. With the increase in feed-rate, increase in bone temperature is lower.

Keywords

Thermal osteonecrosis Bone drilling