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Drill Bone with Both Hands: Plunge Depth and Accuracy with 4 Bracing Positions
Joseph T Patterson1, Jacob A Becerra1, Andrew Duong1
1Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
JB & JS Open Access
|March 6, 2023
Summary
Orthopaedic surgical trainees should avoid one-handed bone drilling. This technique significantly increases drill plunge depth, risking iatrogenic injury. Two-handed methods offer better control and safety during simulated bone drilling tasks.
Area of Science:
- Orthopaedic Surgery
- Surgical Education
- Biomechanical Analysis
Background:
- Bone drilling is a fundamental orthopaedic surgical skill.
- The bracing position used during bone drilling may impact surgical performance and patient safety.
Purpose of the Study:
- To evaluate the effect of four different bracing positions on orthopaedic surgical trainee performance during simulated bone drilling.
- To determine which bracing technique minimizes drill plunge depth and maximizes accuracy.
Main Methods:
- A prospective, randomized crossover study involving 19 orthopaedic surgical trainees.
- Trainees performed simulated bone drilling tasks using one-handed and three different two-handed bracing positions.
- Linear mixed effects models analyzed drilling depth and accuracy, controlling for trainee experience and physical characteristics.
Main Results:
- One-handed drilling resulted in significantly greater drill plunge depth compared to all tested two-handed positions (p < 0.038).
- No significant difference in drilling accuracy was observed between any of the bracing positions (p = 0.227).
- Interactions between participant height and plunge depth, and drill hole number and plunge depth were noted.
Conclusions:
- Orthopaedic surgical educators should discourage one-handed bone drilling by trainees.
- Adopting two-handed bracing techniques is recommended to reduce the risk of iatrogenic injury from excessive drill plunging.
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