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Abstract
The aetiology, frequency and consequences of drill bit failure during surgical intervention
in human and animal bone tissue are investigated and discussed to provide the surgeon
confronted with this problem with a scientifically based procedure. The literature
on this subject is rather inadequate, i.e. only one publication in the last decade
could be found dealing with this topic and this was a veterinary case. The Laboratory
for Experimental Surgery in Davos has received several enquiries from the medical
profession worldwide as to correct procedure in the case of drill bit failure.
Three sources of information were investigated in order to furbish a reply to these
enquiries, these were the AO/ASIF documentation centre in Berne, a survey of 280 surgeons
and orthopedic doctors in Switzerland and a survey of 83 AO/ASIF foundation members.
One broken tap (tool steel) was removed two years after the operation and metallographic
investigations carried out. A frequency of 3 drill bit failure per 1000 internal fixations
(0.3 %) is apparent in nearly all data. The reasons for drill bit failure were investigated.
Drill bit failure occurs more frequently in the proximal femur and when using angled
plates. On the basis of this enquiry the following guidelines can be offered to the
surgeon. A broken drill bit which is not in contact with an implant can be left in
the body without any risk of delayed recovery. However, if the drill fragment is situated
near a joint or if it can be easily removed without further trauma to the bone, then
it should be removed.
Once the fracture has healed the broken drill bit should be removed along with the
implant provided no exceptional difficulties are involved.
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References
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© 1992 Published by Elsevier Inc.
