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  • Effect of K-wire Reuse and Drill Mode on Heat Generation in Bone

    Author(s)
    Muriuki, MG
    Reddy, AK
    Tauchen, A
    Havey, RM
    Patwardhan, AG
    Bindra, RR
    Griffith University Author(s)
    Bindra, Randy
    Year published
    2021
    Metadata
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    Abstract
    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, P ...
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    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, P =.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, P =.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, P =.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.
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    Journal Title
    Hand
    DOI
    https://doi.org/10.1177/15589447211003172
    Note
    This publication has been entered in Griffith Research Online as an advanced online version.
    Subject
    Clinical sciences
    bone damage
    drilling bone
    heating rate
    oscillating mode
    rotary mode
    Publication URI
    http://hdl.handle.net/10072/404915
    Collection
    • Journal articles

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