Comparison of Power Tool Modes Used for Kirschner Wire Driving: Forward & Reverse (F&R) Mode – Oscillation Mode

Luo et al. tried 4 techniques used by surgeons in K-wire insertion procedures. (2019)

• Continuous drilling: It is to continuously thrust the K-wire towards the bone with an increasing thrust force. This method further increased heat generation by creating higher friction force and excessive tool wear. This method is shown in Figure 2 in red.
• Shaky drilling: In this drilling technique, the surgeon performs the wire driving process by making small vibrations back and forth in the axis of the K-wire. This method is shown in Figure 2 in green. This method helped to reduce heat by helping to evacuate bone debris. Even if you try to thrust continuously in the oscillation mode, this is impossible because the direction of rotation will reverse, and it will be an example of shaky drilling. Therefore, it could not be shown in red in the continuous drilling section in the oscillation mode graph in Figure 2.
• Intermitten drilling: Surgeons created one or two notches in the thrust profile, such as the blue curves in Figure 2, by gently retracting the surgical power tools once or twice during drilling. Evacuation of bone debris was done more efficiently. With this technique, surgeons achieved the fastest drilling time and the lowest increase in bone temperature. (In F&R mode)
• Pecking drilling: Surgical power tool retraction is performed more frequently by the surgeon. It is shown as a black line in Figure 2. Multiple notches in the thrust force applied to the surgical motor during piercing (in other words pushing and retracting too much of the power tool) were not efficient due to prolong the drilling time. Since the time is prolonged, the contact time of the heat with bone has increased.