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Related Experiment Videos

Temperature rise during reamed tibial nailing.

P V Giannoudis1, S Snowden, S J Matthews

  • 1Department of Trauma, St James's University Hospital, Beckett Street, Leeds, United Kingdom.

Clinical Orthopaedics and Related Research
|April 9, 2002
PubMed
Summary

Tibial intramedullary nailing generates heat during reaming. Smaller tibial canals (8 mm) reamed to larger sizes show a significant temperature rise, but clinical complications were not observed.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Intramedullary nailing is a common orthopedic procedure for tibial fractures.
  • Heat generation during surgical reaming is a potential concern for bone viability.

Purpose of the Study:

  • To quantify intraoperative temperature rise during reamed tibial intramedullary nailing in vivo.
  • To investigate the relationship between reaming extent, canal diameter, and heat production.

Main Methods:

  • Eighteen adult patients undergoing tibial intramedullary nailing were studied.
  • Medullary canals were reamed using AO reamers.
  • Temperature was monitored in cortical bone using platinum resistance thermometer probes and a data logger.

Main Results:

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  • Mean pre-reaming tibial temperature was 35.6°C; peak temperatures ranged from 36.1°C to 51.6°C.
  • A direct correlation was found between the amount of reaming and temperature elevation.
  • Reaming 8 mm canals above 10 mm resulted in a statistically significant higher temperature rise compared to larger canals.

    • Conclusions:

    • Reaming smaller tibial canals (8 mm) to larger sizes may induce significant heating.
    • Standard reaming for 9-11 mm canals did not lead to thermal complications or affect bony healing.
    • The heating effect from reaming appears clinically manageable in most tibial intramedullary nailing procedures.