BACKGROUND: Kirschner wires (K-wires) are commonly used in orthopedic surgery. However, the loosening of the pins can lead to delayed or improper healing or infection. Wire loosening can occur by thermal necrosis that occurs due to heat produced during wire insertion. Although the parameters that affect temperature rise in cortical bone during wire insertion and drilling have been studied, the effect of drilling mode (oscillation versus forward) is unknown. The purpose of this study was to compare the temperature changes occurring in cortical bone during wire insertions by oscillating and forward drills. Our hypothesis is that oscillation drilling would produce less heat compared with forward drilling in K-wire insertion with 2 commonly used wire diameters. METHODS: We drilled K-wires in a pig metacarpal model and measured the temperature rise between forward and oscillation drilling modes using diamond-tipped 0.062- and 0.045-inch-diameter K-wires. There were 20 holes drilled for each group (n = 20). RESULTS: The average temperature rise using the 0.062-inch K-wire under forward and oscillation insertion was 14.0 ± 5.5°C and 8.8 ± 2.6°C, respectively. For the 0.045-inch K-wire, under forward and oscillation insertion, the average temperature rise was 11.4 ± 2.6°C and 7.1 ± 1.9°C, respectively. The effects of the drilling mode and wire diameter on temperature rise were significant ( P < .05). CONCLUSIONS: In conclusion, the oscillation of K-wires during insertion causes a lower temperature rise when compared with forward drilling.
BACKGROUND: Kirschner wires (K-wires) are commonly used in orthopedic surgery. However, the loosening of the pins can lead to delayed or improper healing or infection. Wire loosening can occur by thermal necrosis that occurs due to heat produced during wire insertion. Although the parameters that affect temperature rise in cortical bone during wire insertion and drilling have been studied, the effect of drilling mode (oscillation versus forward) is unknown. The purpose of this study was to compare the temperature changes occurring in cortical bone during wire insertions by oscillating and forward drills. Our hypothesis is that oscillation drilling would produce less heat compared with forward drilling in K-wire insertion with 2 commonly used wire diameters. METHODS: We drilled K-wires in a pig metacarpal model and measured the temperature rise between forward and oscillation drilling modes using diamond-tipped 0.062- and 0.045-inch-diameter K-wires. There were 20 holes drilled for each group (n = 20). RESULTS: The average temperature rise using the 0.062-inch K-wire under forward and oscillation insertion was 14.0 ± 5.5°C and 8.8 ± 2.6°C, respectively. For the 0.045-inch K-wire, under forward and oscillation insertion, the average temperature rise was 11.4 ± 2.6°C and 7.1 ± 1.9°C, respectively. The effects of the drilling mode and wire diameter on temperature rise were significant ( P < .05). CONCLUSIONS: In conclusion, the oscillation of K-wires during insertion causes a lower temperature rise when compared with forward drilling.
Authors: Andrew C Palmisano; Bruce L Tai; Barry Belmont; Todd A Irwin; Albert Shih; James R Holmes Journal: J Orthop Res Date: 2015-09-24 Impact factor: 3.494
Authors: M J Botte; J L Davis; B A Rose; H P von Schroeder; H Gellman; E M Zinberg; R A Abrams Journal: Clin Orthop Relat Res Date: 1992-03 Impact factor: 4.176