Extent of bluntness and damage to reamers from hospitals

The negative effects of intramedullary nailing, such as aseptic cortical necroses and fat embolisms, are mainly caused by an increase in intramedullary pressure and an increase in cortical temperature during the reaming process. The degree of bluntness of the reamers has a negative influence on these two parameters. The objective of this study was to examine the degree of bluntness and damage to intramedullary reamers in clinical use. 10 sets of intramedullary reamers returned from Swiss clinics were examined with regard to the radius of the cutting edge and the degree of damage. The following results were established (MN = medullary nailings): Sharpest reamers: hospitals with 300-400 beds. Hospitals with < 5 MN per year. Bluntest reamers: hospitals with > 1000 beds. Hospitals with 40-60 MN/year. Least damaged reamers: hospitals with 300-400 beds. Hospitals with 40-60 MN/year Most damaged reamers: hospitals with > 1000 beds. Hospitals with 40-60 MN/year Due to the fact that some of the reamers in clinical use are of inadequate quality both with regard to the sharpness of the milling lips and the degree of damage, doctors and operating staff should be instructed to check the quality of cutting tools before using them, to treat them carefully and to replace them if necessary.