Can a surgeon drill accurately at a specified angle?

Valentina Brioschi, Jodie Cook, Gareth I Arthurs, Valentina Brioschi, Jodie Cook, Gareth I Arthurs

Abstract

Objectives: To investigate whether a surgeon can drill accurately a specified angle and whether surgeon experience, task repetition, drill bit size and perceived difficulty influence drilling angle accuracy.

Methods: The sample population consisted of final-year students (n=25), non-specialist veterinarians (n=22) and board-certified orthopaedic surgeons (n=8). Each participant drilled a hole twice in a horizontal oak plank at 30°, 45°, 60°, 80°, 85° and 90° angles with either a 2.5 or a 3.5 mm drill bit. Participants then rated the perceived difficulty to drill each angle. The true angle of each hole was measured using a digital goniometer.

Results: Greater drilling accuracy was achieved at angles closer to 90°. An error of ≤±4° was achieved by 84.5 per cent of participants drilling a 90° angle compared with approximately 20 per cent of participants drilling a 30-45° angle. There was no effect of surgeon experience, task repetition or drill bit size on the mean error for intended versus achieved angle. Increased perception of difficulty was associated with the more acute angles and decreased accuracy, but not experience level.

Clinical significance: This study shows that surgeon ability to drill accurately (within ±4° error) is limited, particularly at angles ≤60°. In situations where drill angle is critical, use of computer-assisted navigation or custom-made drill guides may be preferable.

Keywords: bone drilling; drill angle; drilling accuracy.

Figures

FIG 1:
FIG 1:
Box plot illustrating the error attained for each experience-level group at each specified drilling angle. The ends of the whiskers represent the lowest datum still within 1.5 IQR of the lower quartile, and the highest datum still within 1.5 IQR of the upper quartile. Any data not included between the whiskers was considered an outlier (represented with a dot). Outliers were the result of a participant drilling incorrectly at both attempts of the same angle; however, each outlying value relates to a separate participant (i.e. it was not the same individual drilling consistently at an incorrect angle)
FIG 2:
FIG 2:
Percentage of participants within groups achieving error margin ≤4°

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Source: PubMed

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