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Surgical Drill Bit Design and Thermomechanical Damage in Bone Drilling: A Review

Akhbar MFA, Sulong AW

Ann Biomed Eng, 2021 Jan;49(1):29-56.
PMID: 32860111 DOI: 10.1007/s10439-020-02600-2

As drilling generates substantial bone thermomechanical damage due to inappropriate cutting tool selection, researchers have proposed various approaches to mitigate this problem. Among these, improving the drill bit design is one of the most feasible and economical solutions. The theory and applications in drill design have been progressing, and research has been published in various fields. However, pieces of information on drill design are dispersed, and no comprehensive review paper focusing on this topic. Systemizing this information is crucial and, therefore, the impetus of this review. Here, we review not only the state-of-the-art in drill bit designs-advances in surgical drill bit design-but also the influences of each drill bit geometries on bone damage. Also, this work provides future directions for this topic and guidelines for designing an improved surgical drill bit. The information in this paper would be useful as a one-stop document for clinicians, engineers, and researchers who require information related to the tool design in bone drilling surgery.

Matched MeSH terms: Bone and Bones/injuries
The synthesis, characterization and in vivo study of mineral substituted hydroxyapatite for prospective bone tissue rejuvenation applications

Govindaraj D, Rajan M, Munusamy MA, Alarfaj AA, Sadasivuni KK, Kumar SS

Nanomedicine, 2017 Nov;13(8):2661-2669.
PMID: 28800874 DOI: 10.1016/j.nano.2017.07.017

Minerals substituted apatite (M-HA) nanoparticles were prepared by the precipitation of minerals and phosphate reactants in choline chloride-Thiourea (ChCl-TU) deep eutectic solvent (DESs) as a facile and green way approach. After preparation of nanoparticles (F-M-HA (F=Fresh solvent)), the DESs was recovered productively and reprocess for the preparation of R-M-HA nanoparticles (R=Recycle solvent).The functional groups, phase, surface texture and the elemental composition of the M-HA nanoparticles were evaluated by advance characterization methods. The physicochemical results of the current work authoritative the successful uses of the novel (ChCl-TU) DESs as eco-friendly recuperate and give the medium for the preparation of M-HA nanoparticles. Moreover, the as-synthesized both M-HA nanoparticles exhibit excellent biocompatibility, consisting of cell co-cultivation and cell adhesion, in vivo according to surgical implantation of Wistar rats.

Matched MeSH terms: Bone and Bones/injuries*
Development of a synthetic bone scaffold using porous hydroxyapatite for bone repair

Mustaffa R, Besar I, Andanastuti M

Med J Malaysia, 2008 Jul;63 Suppl A:95-6.
PMID: 19025001

In this study, porous hydroxyapatite (HA) samples were fabricated via sponge techniques with the aid of sago as part of the binder mixture. Development processes for the production of porous bone graft substitutes are studied using polyurethane sponge. To obtain the optimum amount of binder for successful fabrication of porous HA were done. Initially, porous HA powder was synthesized using calcium hydroxide and orthorphosphoric acid. Meanwhile, sago was mixed with PVA in a certain ratio to be used as binder for preparing the porous HA. After a series of investigative tests were conducted to characterize the sintered samples, the use of the sago and polymeric mixture was found to successfully aid the fabrication of porous HA samples. In this investigation, comparison of physical and mechanical characteristics between samples prepared using difference techniques was made.

Matched MeSH terms: Bone and Bones/injuries
Fulltext An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries

Chew KS, Shaharudin AH

Singapore Med J, 2017 Oct;58(10):601-605.
PMID: 27193080 DOI: 10.11622/smedj.2016096

INTRODUCTION: The use of intranasal fentanyl as an alternative type of analgesia has been shown to be effective in paediatric populations and prehospital settings. There are a limited number of studies on the use of intranasal fentanyl in adult patients in emergency settings.
METHODS: An open-label study was conducted to evaluate the effectiveness of the addition of 1.5 mcg/kg intranasal fentanyl to 2 mg/kg intravenous tramadol (fentanyl + tramadol arm, n = 10) as compared to the administration of 2 mg/kg intravenous tramadol alone (tramadol-only arm, n = 10) in adult patients with moderate to severe pain due to acute musculoskeletal injuries.
RESULTS: When analysed using the independent t-test, the difference between the mean visual analogue scale scores pre-intervention and ten minutes post-intervention was 29.8 ± 8.4 mm in the fentanyl + tramadol arm and 19.6 ± 9.7 mm in the tramadol-only arm (t[18] = 2.515, p = 0.022, 95% confidence interval 1.68-18.72 mm). A statistically significant, albeit transient, reduction in the ten-minute post-intervention mean arterial pressure was noted in the fentanyl + tramadol arm as compared to the tramadol-only arm (13.35 mmHg vs. 7.65 mmHg; using Mann-Whitney U test with U-value 21.5, p = 0.029, r = 0.48). There was a higher incidence of transient dizziness ten minutes after intervention among the patients in the fentanyl + tramadol arm.
CONCLUSION: Although effective, intranasal fentanyl may not be appropriate for routine use in adult patients, as it could result in a significant reduction in blood pressure.

Matched MeSH terms: Bone and Bones/injuries*