CHEN Chengwei,SHEN Cuihua,ZHAN Chao, et al. Study of screw pilot channel placement in the locking plates using the safety dril[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(1): 45-.
Abstract：Objective: To make use of the safety drill to deal with the placement of the screw pilot in the femoral head through proximal femoral locking plate, test the safety properties of the new safety drill compared with conventional drill. Methods: Twenty femoral heads for hole-drilling research were taken from the femoral neck fracture patients while having the hip arthroplasty in the department of orthopaedic in the 1st affiliated hospital of Wenzhou Medical University. Numbered all these femoral heads, divided them randomly into 2 groups. The N group was carried out drilling test with the new safety drill, while the O group with the traditional drill. All femoral heads were fixed firmly into Fixture in the self-made box in the same manner. Group N was carried out drilling test by new drill. All the participants were asked to perform 4 holes through the prepared pilot apparatus of the locking plate in the same order, starting with new drill clockwisely twice and then anti-clockwisely twice. They were informed to drill as deeply as they could do, but not to penetrate the joint. The drilling depth was recorded in millimeters by depth sounder after all the holes was drilled. Then they were ask to penetrate all the hole and the whole drilling depth were obtained. The difference between the two records was define as TED (tip-to-edge distance) for evaluation. Group O was carried out drilling test with traditional drill. All the participants were asked to perform 4 holes in the same manner as mentioned above. But they were informed to penetrate all the joint and record the perception of dynamics using Visual analog scales (VAS) for evaluation. Results: Ten orthopaedic surgeons took part in the tests, Mean TED for Nc, Na, Oc, Oa were respectively 5.75, 2.95, 6.55 and 3.20 mm. Mean VAS for Nc, Na, Oc, Oa were respectively 5.90, 9.55, 2.85 and 6.75 score. The drill type (factor A) for TED had no significant difference (FA=3.2603, P=0.1263) while the drill direction (factor B) for TED was statistically different (FB=294.1222, P=0.0000). The factor A and factor B for VAS had both statistically significant difference (FA=158.0891, P=0.0000; FB=378.8507, P=0.0000). Conclusion: The safety drill with reverse drilling technique (Na group) offersd a better TED while showing a higher safe threshold for penetration, which means a greater stability between screws and lower incidence of UJP.
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