A Technique for Removal of Broken Cannulated Drill Bit: Bassi's Method

Abstract

Broken drill bits constitute the largest proportion of broken orthopedic instruments. We report a new technique which allows atraumatic removal of cannulated drill bits. The technique is simple and does not require any special instrumentation.

Modeling and experimentation of bone drilling forces

“…Large drilling forces and torques cause frequent drill-bit breakage (Farnworth and Burton, 1974;Jantunen, 2002;Stein and Dornfeld, 1997); since it could obstruct placement of other devices and cause adverse histological effects, follow-on procedures for removal of the broken drill bit are commonly required (Bassi et al, 2008;Price et al, 2002). Similarly, uncontrolled forces may result in drill breakthrough, imparting considerable damage to surrounding tissue (Brett et al, 2004;Kendoff et al, 2007;Ong and Bouazza-Marouf, 1999).…”

Drilling of Bone: Practicality, Limitations and Complications Associated with Surgical Drill-Bits

“…Intraoperative complications associated with the use of drill-bits includes drill-bit breakage (Fothi, Perren et al 1992;Hirt, Auer et al 1992;Benirschke, Melder et al 1993;Miller 2002;Price, Molloy et al 2002;Matthews, Landsmeer et al 2006;Bodner, Woldenberg et al 2007;Bassi, Pankaj et al 2008;Pichler, Mazzurana et al 2008;Gupta, Singh et al 2009;Kosy and Standley 2010) and heat generation (Berning and Fowler). Another cause for concern, albeit a rarely reported complication, is microfracture of host bone adjacent to the drilled defect.…”

“…It is reported that the drill-bit is the most frequently broken surgical instrument (Fothi, Perren et al 1992;Hirt, Auer et al 1992;Miller 2002;Price, Molloy et al 2002;Pichler, Mazzurana et al 2008) which represents a considerable dilemma for surgeons due to the complexities associated with removal of the broken portion from either the bone or medullary canal (Matthews, Landsmeer et al 2006;Bassi, Pankaj et al 2008). Actual breakage rates have been reported to vary between 0.14% (11/7,775 orthopaedic cases) (Price, Molloy et al 2002), 0.194% (23/11,856 orthopaedic cases) (Pichler, Mazzurana et al 2008) and 0.3% (3/1000 internal fixation procedures) (Hirt, Auer et al 1992).…”

Drilling in cortical bone: a finite element model and experimental investigations

“…Similarly, drilling forces are the major contributor to heat generation during bone drilling (Augustin et al 2008), which can cause thermal necrosis (Eriksson et al 1984, Bachus et al 2000, Davidson et al 2003. Previous studies (Farnworth et al 1974, Bassi et al 2008, Price et al 2002 have shown that uncontrolled drilling forces and torques could cause surgical complications due to the drill-bit breakage. It is also important in manual bone drilling to learn to anticipate drill-bit breakthrough and the necessary change in force depending on the quality and density of the bone, which is anisotropic and living.…”