Introduction: Many orthopaedic procedures require drilling of bone, especially fracture repair cases. Bone drilling results in heat generation due to the friction between the bone and the drill bit. A high level heat generation kills bone cells. Bone cell death results in resorption of bone around bone screws. Materials and methods: Many points of view of orthopaedists and neurosurgeons based upon on previous practices and clinical experience are presented. Results: Several potential complications are discussed and highlighted that lead to thermal necrosis. Discussion: Even in the face of growing evidence as to the negative effects of heatinduction during drilling, simple and effective methods for monitoring and cooling in realtime are not in widespread usage today. For that purpose, we propose some suggestions for the future of bone drilling, taking note of recent advances in autonomous robotics, intelligent systems, and computer simulation techniques. Conclusions: These advances in prevention of thermal necrosis during bone drilling surgery are expected to reduce the risk of patient injury and costs for the health service.

Angioleiomyomas are relatively rare benign smooth muscle soft tissue tumors which often occur on the extremities. They are rarely diagnosed preoperatively as clinical and radiological examination is often nonspecific and inconclusive. An 80-year-old male presented with a 10-year history of a progressively growing and symptomatic lesion on his right dorsal foot within the first intermetatarsal space. The preoperative diagnosis was suspected to be a neurogenic schwannoma arising from the deep peroneal nerve. Simple excision and histopathology confirmed a diagnosis of angioleiomyoma with nil recurrence or complications. The size of the angioleiomyoma was the second largest reported in literature to date. Angioleiomyomas are often misdiagnosed, and a degree of suspicion should be maintained in patients presenting with lower extremity growing soft tissue tumors.

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