Abstract
Repairing whole bone fractures requires surgical drilling to create pilot holes for easy insertion of cortical screws, cancellous screws, and locking bolts to align adjacent bone fragments, apply fracture plates, or insert fracture nails. Although drilling may be done using CO2 pulsed lasers, haptic systems that offer tactile force and torque feedback, and teleoperation in which a surgeon conducts the procedure off-site, electrically-powered hand drills remain the common clinical practice. Force and torque generated at the drill bit–bone interface are influenced by feed rate (i.e., linear speed of the drill bit into bone), spindle speed (i.e., rotational speed of the drill bit), drill bit tip angle (i.e., angle of the pointed tip of the drill bit), drill bit size (i.e., outer diameter), and bone type (i.e., cortical vs. cancellous, normal vs. osteoporotic, human vs. animal, etc.). Nonoptimal force and torque can raise temperatures, causing bone necrosis, as well as poor pilot hole quality, causing poor screw fixation. Consequently, optimization of drilling force and torque is a clinically relevant topic. Therefore, this chapter explains how to measure force and torque during surgical drilling into whole bone, as well as how to analyze, present, and interpret the results.
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