In vitro comparison of cortical bone temperature generation between traditional sequential drilling and a newly designed step drill in the equine third metacarpal bone

Summary

Objectives: To compare heat generation and time to finish between a new step drill and sequential drilling in order to create a 6.2 mm pilot hole for insertion of a positive profile transfixation pin into the equine third metacarpal bone.

Methods: Nine pairs of equine third metacarpal bones from cadavers of adult horses were used. Maximum temperature rise of the bone was measured continuously at the cis- and trans-cortices 1, 2 and 3 mm from the final pilot hole during creation of a 6.2 mm hole using a step drill and sequential drilling with 4.5, 5.5 and 6.2 mm drill bits. Five holes were drilled into the mid diaphysis of each bone in lateral to medial direction, and drilling forces of 60, 80 and 120 N were used (15 holes in each group). Time from start to finish was measured and cortical thickness was recorded for each hole.

Results: The maximum heat generation (mean [95% CI]) with step drilling and sequential drilling was not significantly different at 60 N and 120 N of drilling force. However, at 80 N of drilling force, the 2.13 ºC difference between the two drilling techniques was significant. The time to finish (seconds) was significantly shorter for the holes created by step drilling (35.1 [32.06 – 37.59]) than by sequential drilling (145.8 [138.52 – 151.67]) (P < 0.001).

Clinical Relevance: Based on our results, we concluded that the step drill is a viable alternative to traditional sequential drilling of equine third metacarpal bone because it did not result in excessive heat generation that can result in bone necrosis.

Keywords

Bone temperature during drilling - transfixation pin cast - step drill - equine - fracture

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