|Year : 2019 | Volume
| Issue : 3 | Page : 49-51
Hardware/engineering battery-operated drills are more cost-effective as compared to orthopedic drills
Sneh Prabhakar, Avtar Singh, Rajeev Vohra, Kanwar Kulwinder Singh, Inderdeep Singh
Department of Orthopaedics, Amandeep Hospital, Amritsar, Punjab, India
|Date of Submission||18-Sep-2019|
|Date of Decision||01-Oct-2019|
|Date of Acceptance||10-Oct-2019|
|Date of Web Publication||23-Dec-2019|
Department of Orthopaedics, Amandeep Hospital, Amritsar - 143 001, Punjab
Source of Support: None, Conflict of Interest: None
Background: Drilling of the bone is common to produce holes for screws and pin insertion, to fix the fractured parts for immobilization. For this purpose, we need a power drill machine. Power drills used in orthopedic surgery can be categorized into two types: electrical and battery operated. Battery-operated drills could be orthopedic drills or hardware engineering drills. Commercial orthopedic battery drills (OBDs) are very costly. However, the same purpose can be subserved by hardware/engineering battery drill (HBD or EBD), with some additional practical advantages. Purpose: The purpose of this study is to aware the orthopedic surgeons who are working at resource constraint places about the advantages of EBD which is available at a very low price and serves the same purpose. Methods: We are using these battery operated hardware/engineering drills from quite a period of time and we have immense experiences with these EBD. The present article discusses in details about both the OBD and EBD. We assessed both drills by our own practical experience and compared both drills' specifications. Research Performance Place: The present study was conducted at Amandeep Hospital, G. T. Road, Model Town, Amritsar, Punjab, India. +91-98760-02746, 9876046778, E-mail: firstname.lastname@example.org. It is a research institute with super specialty and multispecialty offering postgraduation courses and residency with national and international fellowships and observerships. Results: After comparing both the drills, we found that EBD is a very good substitute for OBD in orthopedic surgery in various aspects, namely availability, procurement, functionalities, servicing, and maintenance and is very cost-effective too. Conclusion: Hardware / engineering battery drills are very good and practical alternative to orthopedic drills in orthopedic surgeries. Hence, EBD is recommended for hospitals with limited resources and where treatment cost is an issue. Level of Evidence: 5.
Keywords: Battery, cost-effective, drill, hardware, orthopedics
|How to cite this article:|
Prabhakar S, Singh A, Vohra R, Singh KK, Singh I. Hardware/engineering battery-operated drills are more cost-effective as compared to orthopedic drills. J Orthop Dis Traumatol 2019;2:49-51
|How to cite this URL:|
Prabhakar S, Singh A, Vohra R, Singh KK, Singh I. Hardware/engineering battery-operated drills are more cost-effective as compared to orthopedic drills. J Orthop Dis Traumatol [serial online] 2019 [cited 2020 Aug 15];2:49-51. Available from: http://www.jodt.org/text.asp?2019/2/3/49/273881
| Introduction|| |
Bone fracture treatment usually involves restoring of the fractured parts to their initial position and immobilizing them until the healing takes place. Drilling of the bone is common to produce holes for screws and pin insertion to fix the fractured parts for immobilization. For this purpose, we need a power drill machine. Power drills used in orthopedic surgery can be categorized into two types: electrical and battery operated. Battery-operated drill has some clear advantages over electrical, but commercial orthopedic battery drills (OBDs) [Figure 1] are very costly. This article discusses the use of “hardware”/engineering battery drill (EBD) in orthopedic surgery. EBDs are having a clear advantage over OBDs. Although it is a departure from ideally what is recommended for surgical practice, but our experience shows these EBDs are practically a very good option. We present our view in this article on cost-effectiveness and practicality of EBD as compared to OBD. Below are the technical details of EBD.
Prototype EBD taken in this study is Black and Decker CD121K50, and OBD is from Stryker system 6.
Warranty period – Six months warranty, Model No: CD121K50, Brand: Black and Decker Drilling Capacity and Contents of the Kit; the maximum drilling capacity of the drill is 15 mm on wooden surfaces and 10 mm on steel.
Cordless impact drill is capable of ten different torque settings for hard screw driving applications. The powerful motor lends the drill a powerful no-load speed of 1200 rpm. With a firm-grip handle, which reduces effort and improves handling, the drill is powered by a 12 V Li-ion battery. Equipped with the Spring-loaded Slide Pack Battery System, removal and installation of the battery is easy. Provided with a charging dock, the EBD used by us is from Black and Decker company [Figure 2]. The EBD has got a plastic body which has a mouth and detachable battery. The mouthpiece has revolving assemblies which holds kwires/drill bit/reamers/screw drivers. The whole drill comes with total manual operation. No Jacobson's chuck and key is required for tightening. The EBD drill is very user friendly. The battery is detachable. The RPM adjustment is done with trigger in the handgrip. The clockwise and anticlockwise revolution is done with an easy push button on either side just above the handgrip. This provides a very easy forward and reverse drilling.
RPM and working mode adjustment can be further done by a manually driven twister just behind the mouth of the drill. Pictorial icons are present over the twister for various modes of operation. Hence, all it becomes a very easy task to use this EBD in orthopedic surgical practice.
Studies have shown that the threshold temperature for human bone necrosis is 47°C. Operating a drill with its maximum torque at 1200 rpm would never cross this threshold temperature even if applied for an indefinite period of time. This is because the graph plotted for bone temp against RPM of drill is a bell shaped [Figure 3]. This means bone tempearture is directly proportional to RPM value, but it starts decreasing after an RPM of 10,000. We can get a maximum output of 12,000 rpm with this EBD. After using the drill, cleansing is done with a gauge wet in alcohol-based disinfectant. We use 10% alcohol solution. Then, drill is allowed to dry and kept in airtight two plastic bags, which are then sent to ethylene oxide treatment for sterilization [Figure 4]. After sterilization, this drill is again ready to use. We could not find any infection in our patients attributable to this EBD or sterilizing procedure used in this EBD. Because of being battery operated, this drill is wireless, and hence, using this drill is totally hassle-free. A surgeon can move with drill anywhere in the desired direction. If battery is exhausted, replaceable and rechargeable batteries are available on the table.
|Figure 3: Graph showing relation between bone temperature drilling time and torque applied|
Click here to view
Being cheap in the price, we can use as many drills as required in setups with multiple operating rooms. The cost of EBD is 4000 INR, whereas the cost of orthopedic drill machine is about 500,000 INR [Table 1]., Hence, EBD is a way cheaper as compared to OBD. The general concerns about the HBD are sterility, smoothness, and maintenance. Sterility as we have discussed earlier is done by ethylene oxide chamber. As autoclaving cannot be done for plastics, we have not found any infection in our cases which are attributable to drill. Smoothness; since EBD is run through machine (Electric Motor) so its smooth, no matter on which speed we are working. We can control the RPM with a revolving twister on top. Since speed is controllable, heat necrosis of the bone is not an issue. The drill can be used in almost all orthopedic procedure, namely drilling, screw tightening, K-wiring, reaming, and tapping because of its user-friendly design and adequate power. Further, because of being cheap, we can use two to three drills on the table for each for drilling and screw tightening. This definitely reduces surgeons' fatigue and operating time. Maintenance is also not at all an issue. All it requires is only cleansing with an alcohol-based solution, followed by sterilizing in ETO chamber. Being designed for tough hardware drilling, this drill well sustains our orthopedic drilling procedure, so the life span of this drill is also not at all an issue. Any malfunctioning faced is well serviced without any delay.
Disadvantages are being noncannulation and no K-wire gripping trigger for length adjustments of K-wires. These gripping triggers are present in OBD which provides easy and quick length adjustment of K-wire and does not require cutting of K-wire if we need a shorter K-wires. The EBD also does not have the assembly for sagittal saw fitment.
| Conclusion|| |
Being cheap, users friendly, with multiple functionalities in orthopedic surgeries, locally procured and easily serviced, low maintenance cost, tough, and durable, these EBDs are very good substitutes for OBD in hospitals where surgical cost is an issue and resources are constrained.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Satish BR, Shahdi M, Ramarao D, Ranganadham AV, Kalamegam S. Use of hardware battery drill in orthopedic surgery. Arch Bone Jt Surg 2017;5:114-6.
Pandey RK, Panda SS. Drilling of bone: A comprehensive review. J Clin Orthop Trauma 2013;4:15-30.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]