Thermal burns associated with high-speed cortical drilling

Three cases of thermal burns to the anterior tibia are reported to bring attention to this complication resulting from the use of high-speed air-power equipment in the drilling of the tibial pin in ankle arthrodesis. In each case, excess heat was generated at the pin-bone interface, which was followed by a full-thickness burn. In the first case, debridement led to complete wound healing. In the second, a myocutaneous pedicle was required, and in the third, osteomyelitis resulted. This complication may hopefully be avoided by predrilling the bone and observing recommended methods of heat dissipation.