A new universal 3D-printable device to prevent excessive drilling in orthopedic surgery.

Abstract

The occurrence of vascular injury during drilling is a rare but severe complication. Unfortunately, drilling protection systems are not available in all hospitals. Thanks to the development of 3D printing in recent years, sharing devices and materials to solve surgical problems has become easy and inexpensive. The objective of our work is to evaluate a universal, freely accessible, 3D-printable drilling protection device. A prospective, randomized, and triple-blind evaluation of excess drilling was evaluated in expert surgeons and resident surgeons without the use of the protection device. Subsequently, excess drilling was assessed using the device in both groups. The differences in drilling lengths between both groups with and without the device were analyzed to establish the reduction of excess drilling in both groups. The drilling in the expert surgeon without device group was 3.03mm (SD 1.69 95% CI 2.40-3.66 p value = 9.89e-11), while the resident surgeon with device group performed excess drilling of 1.76mm (SD 0.89 CI 95% 1.43-2.10). Results showed better results in the resident surgeon with device group than in the expert surgeons with device group (p value˂0.01). The device improved drilling in both resident surgeons (5.77mm) and expert surgeons (1.17mm). The device improves drilling in both expert surgeons and resident surgeons, showing greater benefits in the latter. The device is printable with any 3D printer, making it universally accessible, inexpensive, and effective, allowing expert surgeons to improve precision in high-risk situations and resident surgeons to improve their technique without increasing risk to the patient.