Archive October 2018 XIX, No. 10

Thinking of Buying... Small Bone Power Tools

Put power and precision in your surgeons' hands

Mike Morsch

Mike Morsch, Associate Editor

BIO

MICRO POWER TOOLS
Pamela Bevelhymer, RN, BSN, CNOR
MICRO POWER TOOLS Speed and torque strongly influence what small bone power tools can do, how easy they are to use and the precision they offer.

Just as in golf you don’t tee off with your putter, in surgery you pick the right power tool for the job. Some are designed for larger operations — like knee and hip replacements — where surgeons need more speed and power, while others are intended for small bone procedures that require more precision and finesse when sawing, shaping, dissecting and drilling bone, or fragmenting, emulsifying and aspirating soft tissue.

“The importance of having specific power tools for what I do is that they’re more precise,” says D. Scott Biggerstaff, MD, a foot and ankle specialist at OrthoCarolina in North Carolina.

Precision is only one of the features to look for when buying small bone power tools. Here are some others to consider:

  • Pencil grip. It doesn’t get any more precise than the pencil grip. The name is exactly what it implies, you hold it like a pencil. The pencil grip is for more intricate, fine-detailed procedures, like nerve repair, wrist arthroscopy, wrist fractures, minimally invasive surgery of the hand and carpal tunnel syndrome. It’s not meant to be used to penetrate the bone but used, for example, to open a small hole in the bone. Speed is important for pencil grips because it prevents the burr from wobbling. But too much power can actually be bad. It could split the bone and make it difficult to control the pencil.
  • Pistol grip. You hold it as you would a power drill that’s stored in your garage. It has a little more power and is used for drilling holes in which to place screws and for some bigger procedures.

“There are some occasional larger osteotomies that I’ll use the pistol grip for because it has more power and the saw blades are a little bigger,” says Dr. Biggerstaff. “You can get the procedure done efficiently and maybe not need as much of the preciseness or accuracy.” • Blade width. When a surgeon wants to shorten a bone, the width of the saw blade is critical. The narrower the blade, the more precise it is. The wider the blade, the more bone it takes and the wider kerf (the narrow channel or slit from cutting) it leaves.

  • Blade width. When a surgeon wants to shorten a bone, the width of the saw blade is critical. The narrower the blade, the more precise it is. The wider the blade, the more bone it takes and the wider kerf (the narrow channel or slit from cutting) it leaves.

“Having a blade with a narrow kerf is very helpful,” says Christopher Lincoski, MD, a hand surgeon at University Orthopedics Center in State College, Pa. “If it has a wide kerf, then I need to figure that into my measurements.” He adds that several factors impact the kerf, including the width of the blade, the set of the blade’s teeth, the amount of wobble created during cutting and the amount of material pulled out of the sides of the cut.

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