Usefulness of a drill stopper to prevent iatrogenic soft tissue injury in orthopedic surgery

Jung Hwan Choi; Young Seok Lee; Kyu-Tae Hwang; Young-Hoon Jo; Hyun Sik Shin; Jihwan Kim; Ki-Chul Park

doi:10.1016/j.heliyon.2023.e20772

Usefulness of a drill stopper to prevent iatrogenic soft tissue injury in orthopedic surgery

Heliyon. 2023 Oct 7;9(10):e20772. doi: 10.1016/j.heliyon.2023.e20772. eCollection 2023 Oct.

Authors

Jung Hwan Choi¹, Young Seok Lee¹, Kyu-Tae Hwang², Young-Hoon Jo¹, Hyun Sik Shin², Jihwan Kim¹, Ki-Chul Park¹

Affiliations

¹ Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Republic of Korea.
² Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, Republic of Korea.

Abstract

Objective: This study introduces a novel technique utilizing a drill stopper to limit drill penetration depth and to prevent iatrogenic injuries, specifically neurovascular damage, in orthopedic surgeries. Orthopedic surgeries frequently involve the use of drills, which are essential tools for various procedures. However, improper handling of drills can lead to iatrogenic soft tissue injuries, causing severe consequences such as permanent disability or life-threatening complications. To address this issue, we propose the use of a drill stopper as a safeguard to prevent excessive drill penetration and reduce the risk of soft tissue damage during surgery.

Materials and methods: The study involved 32 orthopedic surgeons, half of whom were experienced and the other half inexperienced. Synthetic femur bone models (Synbone) were used for drilling exercises, employing four configurations: a sharp drill bit without a stopper (SF, Sharp Free), a sharp drill bit with a stopper (SS, Sharp Stopper), a blunt drill bit without a stopper (BF, Blunt Free), and a blunt drill bit with a stopper (BS, Blunt Stopper). Each participant conducted three trials for each configuration, and the penetration depth was measured after each trial.

Results: For experienced surgeons, the average penetration depths were 3.83 (±1.826)mm for SF, 11.02 (±3.461)mm for BF, 2.88 (±0.334)mm for SS, and 2.75 (±0.601)mm for BS. In contrast, inexperienced surgeons had average depths of 8.52 (±4.608)mm for SF, 18.75 (±4.305)mm for BF, 2.96 (±0.683)mm for SS, and 2.83 (±0.724)mm for BS.

Conclusion: The use of a drill stopper was highly effective in controlling drill penetration depth and preventing iatrogenic injuries during orthopedic surgeries. We recommend its incorporation, particularly when using a blunt drill bit or when an inexperienced surgeon operates in an anatomically unfamiliar area. Using the drill stopper, the risk of severe injuries from excessive drill penetration can be minimized, leading to improved patient safety and better surgical outcomes.