Archive October 2019 XX, No. 10

Thinking of Buying... Small Bone Power Tools

Extremity surgeons look for precision, personal comfort and plenty of versatility in their instruments of choice.

Glenn Gaston

Glenn Gaston, MD

BIO

Don't ignore the big-time importance of choosing the right small bone power tools for your upper and lower extremity surgeons. Here are some of the factors you need to consider when shopping the options.

  • Ergonomics. The most important factor for your surgeons is how a particular power tool feels, how it operates, how it behaves. Think of it like how an athlete or musician feels about a particular model of baseball glove or guitar. Likewise, don't assume that any given small bone power tool is "one-size-fits-all."

Surgeons will know pretty quickly whether a power tool feels right in their hand. Is it their preferred weight? How easy is it to grip? How easy is it to control? Does it feel well-balanced? When surgeons begin drilling, is the speed and power what they expect and require? Remember, different surgeons have different hand sizes and different styles. You want them to feel the maximum amount of comfort and confidence in the tool they're using.

  • Power. Traditionally, small bone power tools needed to be plugged into a power source. Now battery-operated tools offer surgeons a lot more freedom of movement and maneuverability, reduce clutter and cabling snafus.

However, the freedom provided by cordless tools comes at a price: You need to make sure that at any given time you'll have enough tools charged up, so surgeries aren't delayed. When evaluating your options, look at how long each one holds a charge, and how long it takes to recharge. The tool should have a battery power indicator as well. Also keep in mind that with some cordless systems, the battery isn't autoclavable, so it's unsterile. You open the back of the tool, and drop the battery in there.

  • Attachments. This one's pretty straightforward: Does the tool accommodate all of the types and sizes of attachments such as drills and wire drivers that your surgeons need to perform their surgeries? Most will, but you need to confirm with your surgeons and the vendor. Many tools also include universal adapters for increased versatility.
  • Durability. It's hard to gauge how long these power tools will last without needing to be repaired or discarded. Honestly, I don't know if durability ultimately is representative of the product itself or the surgeons who are using them. It's not like we're gentle with these tools in the OR. As any surgeon will tell you, when we pull the trigger and the tool won't run, almost universally we'll ask for a mallet to hit it on the side to hopefully kick it into gear. Make sure there's enough of a supply of these tools in the OR that when one doesn't work, another one is ready to go. If necessary, arrange for loaners or demo units to use if no others are available.
  • Smarter tools. Some newer tools provide feedback that can increase a surgeon's accuracy. Take plunge, for example. When surgeons want to drill through bone without inadvertently "plunging" into good tissue, they benefit from getting feedback about when to stop drilling. I've seen drills that automatically stop when you've reached the end of bone and are about to drill into tissue. It's really neat technology, but it doesn't have widespread adoption yet because it's cost prohibitive. If these more intelligent tools were similar in cost to regular drills, I think they'd be used almost universally. For now, know that experienced surgeons are well-versed in measuring depth manually. I'm not certain the added cost of these high-end tools is worth it when surgeons can take an extra 10 seconds to measure bone depth themselves.

Bottom line: There are many types of these vital surgical tools available, but each of your surgeons should trial the options and share their preferences before you buy. Never try to talk surgeons into using tools they don't feel fully confident about using. OSM

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