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Abstract
The triple reamer is a convenient lool for reaming the proximal femur when using a
sliding screw and plate device, but unnecessarily high temperatures may be generated
within the femoral head while the lateral cortex is being reamed. Nineteen female
patients over 60 years old were randomized to either the standard or a modified reaming
technique with the triple reamer during internal fixation of proximal femoral fractures.
Temperatures generated within the femoral head were measured. Results showed a mean
peak temperature of 51.9° C (range 42–66) using the standard method and 46.3° C (range
40–52) using the modified method (P = 0.07). A significant difference (P < 0.05) was
found in the duration of temperature elevation above the critical 44° C (17.4s vs
5.7s), it being prolonged in the standard group. Even in this osteoporotic patient
group, damaging temperatures which may contribute to the mechanical failure of fixation,
are generated within the femoral head. A simple method to avoid this problem is described.
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References
- Heat induced bone tissue injury.in: Thesis. University of Gothenburg, Goteborg, Sweden1984
- Heat caused by drilling: cortical bone-temperature measure in vivo in patients and animals.Acta Orthop Scand. 1984; 55: 629
- Temperatures measured in human cortical bone when drilling.J Bone Joint Surg [Am]. 1972; 54A: 297
- Temperatures measured during reaming of the femoral head and neck.Clin Orthop. 1989; 241: 200
- On the problem of heat generation in bone cutting — studies on the effects of liquid cooling.J Bone Joint Surg [Br]. 1991; 73B: 13
Article info
Publication history
Accepted:
November 22,
1994
Identification
Copyright
© 1995 Published by Elsevier Inc.
