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Temperature Rise in Kirschner Wires Inserted Using Two Drilling Methods: Forward and Oscillation.

Scott Richard Anderson1, Serkan Inceoglu1, Montri D Wongworawat1

  • 11 Loma Linda University, CA, USA.

Hand (New York, N.Y.)
|May 18, 2017
PubMed
Summary

Oscillating Kirschner wire (K-wire) insertion generates less heat in bone than forward drilling. This finding is crucial for preventing thermal necrosis and ensuring proper healing in orthopedic surgery.

Keywords:
K-wireKirschner wirebidirectionaldrillingforwardoscillationosteonecrosistemperatureunidirectional

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Surgical Techniques

Background:

  • Kirschner wires (K-wires) are essential orthopedic implants.
  • K-wire loosening can cause delayed healing, infection, and thermal necrosis due to heat during insertion.
  • The impact of drilling mode on bone temperature during K-wire insertion is not well understood.

Purpose of the Study:

  • To compare temperature changes in cortical bone during K-wire insertion using oscillating versus forward drilling modes.
  • To investigate the influence of drilling mode on heat generation during K-wire placement.
  • To test the hypothesis that oscillation drilling reduces heat compared to forward drilling for K-wire insertion.

Main Methods:

  • K-wires of 0.062- and 0.045-inch diameters were inserted into a porcine metacarpal model.
  • Temperature rise was measured during insertion using both forward and oscillating drilling modes.
  • Twenty holes were drilled for each experimental condition (n=20).

Main Results:

  • Oscillation drilling resulted in significantly lower average temperature rises for both K-wire diameters compared to forward drilling.
  • For the 0.062-inch K-wire, average temperature rise was 8.8°C (oscillation) vs. 14.0°C (forward).
  • For the 0.045-inch K-wire, average temperature rise was 7.1°C (oscillation) vs. 11.4°C (forward).

Conclusions:

  • Oscillating K-wire insertion significantly reduces heat generation in cortical bone compared to forward drilling.
  • This reduced thermal effect may mitigate risks of thermal necrosis and improve bone healing outcomes.
  • Drilling mode is a significant factor influencing temperature rise during K-wire placement.