Technical and Economic Analysis of the Process of Surgical Bone Drilling and Improvement Potentials

Christian Höller

Research output: ThesisMaster's Thesis

Abstract

Surgical bone drilling is an important preparative procedure for osteosynthesis. Every year, Austrian surgeons drill around 220,000 holes into human bone. The quality of drill holes affects the stability of the fixation after bone fractures. Excessive heat generation during drilling can cause cell death (thermal necrosis) which again weakens the holding strength of the implant. As a result, post-operative complications can compromise the patient’s recovery and cause additional economic costs. The aim of this thesis was to analyse and improve the process of manual surgical bone drilling. For the technical analysis, related research literature has been reviewed. Hence, the most influential factors for the drilling temperature were identified. Furthermore, discarded surgical drill bits from the operation theatre were investigated with the stereo microscope. For the economic analysis, the consequences of thermal necrosis were determined from a biomechanical and economic perspective. For this purpose, interviews with involved people and statistics were used. Surgical bone drilling requires pre- and post-drilling tasks. The overall process was analysed with specific methods from business economics to determine possible weak points. The investigated surgical drill bits from the operation theatre showed excessive signs of wear. The study showed that both geometry and material of common surgical drill bits have room for improvement. Alternative materials with adequate corrosion and wear resistance as well as improved geometrical parameters are recommended. Cooling is the most influential cutting parameter to decrease the bone temperature during drilling and has to be applied wherever possible. Furthermore, a simple practical guideline was developed to improve the drilling process. Also the economic consequences are remarkable, i.e. complications due to inadequate bone drilling increase the economic costs significantly. These results, and more importantly the safety of the patients justify additional efforts to improve the process of surgical bone drilling.
Original languageEnglish
Awarding Institution
  • Graz University of Technology (90000)
Supervisors/Advisors
  • Vallant, Rudolf, Supervisor
  • Kleindienst, Mario, Supervisor
Award date27 Feb 2015
Publication statusPublished - 27 Feb 2015

Keywords

  • Bone Drilling
  • Thermal Necrosis
  • Osteosynthesis
  • Surgical Drill Bits
  • Wear
  • Drilling Parameters

ASJC Scopus subject areas

  • Surgery
  • Biomaterials

Fields of Expertise

  • Advanced Materials Science

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