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Bone blood flow response to surgical trauma
John R Field1, Geoffrey Sumner-Smith
1Orthopedic Unit, Repatriation General Hospital, Flinders University of South Australia, Daws Road, Daw Park, Adelaide, SA 5041, Australia. lantbruks@bigpond.com
Injury
|July 4, 2002
Summary
Drilling screw holes for bone plates causes acute vascular insufficiency in cortical bone. This blood flow obstruction may contribute to bone loss after surgery.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Vascular biology
Background:
- Bone plate design aims to minimize bone contact and preserve blood supply.
- The impact of screw hole drilling on bone vascularity is often overlooked.
Purpose of the Study:
- To investigate the immediate vascular response of cortical bone to the trauma of drilling screw holes.
- To understand how drilling affects blood flow and vessel integrity.
Main Methods:
- Drill holes were created in sheep tibiae and metatarsi.
- Vascular perfusion studies used India ink, disulphine blue, and barium sulfate.
- Histological analysis of decalcified bone was correlated with perfusion imaging.
Main Results:
- Drilling caused localized perfusion deficiencies adjacent to and around the drill sites.
- Radiographs revealed hematoma formation and vascular disruption.
- Histology showed blood vessel occlusion by proteinaceous/cellular material.
Conclusions:
- Drilling screw holes leads to acute, short-term obstruction of cortical blood flow.
- This vascular insufficiency may contribute to osteopenia after bone plate fixation.