Power-Tool Use in Orthopaedic Surgery

Background:. Power tools are an integral part of orthopaedic surgery but have the capacity to cause iatrogenic injury. With this systematic review, we aimed to investigate the prevalence of iatrogenic injury due to the use of power tools in orthopaedic surgery and to discuss the current methods that...

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Autores principales:	Matthew C.A. Arnold, MBChB, BSc(Hons), Sarah Zhao, MBBS, BSc(Hons), Ruben J. Doyle, MEng, PhD, Jonathan R.T. Jeffers, MEng, PhD, Oliver R. Boughton, MBBS, BSc(Hons), MRCS, FHEA, PhD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/a508d9c47e2a4367ab6648a3bb37a06e
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spelling	oai:doaj.org-article:a508d9c47e2a4367ab6648a3bb37a06e2021-11-25T07:59:02ZPower-Tool Use in Orthopaedic Surgery2472-724510.2106/JBJS.OA.21.00013https://doaj.org/article/a508d9c47e2a4367ab6648a3bb37a06e2021-12-01T00:00:00Zhttp://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.21.00013https://doaj.org/toc/2472-7245Background:. Power tools are an integral part of orthopaedic surgery but have the capacity to cause iatrogenic injury. With this systematic review, we aimed to investigate the prevalence of iatrogenic injury due to the use of power tools in orthopaedic surgery and to discuss the current methods that can be used to reduce injury. Methods:. We performed a systematic review of English-language studies related to power tools and iatrogenic injuries using a keyword search in MEDLINE, Embase, PubMed, and Scopus databases. Exclusion criteria included injuries related to cast-saw use, temperature-induced damage, and complications not clearly related to power-tool use. Results:. A total of 3,694 abstracts were retrieved, and 88 studies were included in the final analysis. Few studies and individual case reports looked directly at the prevalence of injury due to power tools. These included 2 studies looking at the frequency of vascular injury during femoral fracture fixation (0.49% and 0.2%), 2 studies investigating the frequency of vertebral artery injury during spinal surgery (0.5% and 0.08%), and 4 studies investigating vascular injury during total joint arthroplasty (1 study involving 138 vascular injuries in 124 patients, 2 studies noting 0.13% and 0.1% incidence, and 1 questionnaire sent electronically to surgeons). There are multiple methods for preventing damage during power-tool use. These include the use of robotics and simulation, specific drill settings, and real-time feedback techniques such as spectroscopy and electromyography. Conclusions:. Power tools have the potential to cause iatrogenic injury to surrounding structures during orthopaedic surgery. Fortunately, the published literature suggests that the frequency of iatrogenic injury using orthopaedic power tools is low. There are multiple technologies available to reduce damage using power tools. In high-risk operations, the use of advanced technologies to reduce the chance of iatrogenic injury should be considered. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.Matthew C.A. Arnold, MBChB, BSc(Hons)Sarah Zhao, MBBS, BSc(Hons)Ruben J. Doyle, MEng, PhDJonathan R.T. Jeffers, MEng, PhDOliver R. Boughton, MBBS, BSc(Hons), MRCS, FHEA, PhDWolters KluwerarticleOrthopedic surgeryRD701-811ENJBJS Open Access, Vol 6, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Matthew C.A. Arnold, MBChB, BSc(Hons) Sarah Zhao, MBBS, BSc(Hons) Ruben J. Doyle, MEng, PhD Jonathan R.T. Jeffers, MEng, PhD Oliver R. Boughton, MBBS, BSc(Hons), MRCS, FHEA, PhD Power-Tool Use in Orthopaedic Surgery
description	Background:. Power tools are an integral part of orthopaedic surgery but have the capacity to cause iatrogenic injury. With this systematic review, we aimed to investigate the prevalence of iatrogenic injury due to the use of power tools in orthopaedic surgery and to discuss the current methods that can be used to reduce injury. Methods:. We performed a systematic review of English-language studies related to power tools and iatrogenic injuries using a keyword search in MEDLINE, Embase, PubMed, and Scopus databases. Exclusion criteria included injuries related to cast-saw use, temperature-induced damage, and complications not clearly related to power-tool use. Results:. A total of 3,694 abstracts were retrieved, and 88 studies were included in the final analysis. Few studies and individual case reports looked directly at the prevalence of injury due to power tools. These included 2 studies looking at the frequency of vascular injury during femoral fracture fixation (0.49% and 0.2%), 2 studies investigating the frequency of vertebral artery injury during spinal surgery (0.5% and 0.08%), and 4 studies investigating vascular injury during total joint arthroplasty (1 study involving 138 vascular injuries in 124 patients, 2 studies noting 0.13% and 0.1% incidence, and 1 questionnaire sent electronically to surgeons). There are multiple methods for preventing damage during power-tool use. These include the use of robotics and simulation, specific drill settings, and real-time feedback techniques such as spectroscopy and electromyography. Conclusions:. Power tools have the potential to cause iatrogenic injury to surrounding structures during orthopaedic surgery. Fortunately, the published literature suggests that the frequency of iatrogenic injury using orthopaedic power tools is low. There are multiple technologies available to reduce damage using power tools. In high-risk operations, the use of advanced technologies to reduce the chance of iatrogenic injury should be considered. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
format	article
author	Matthew C.A. Arnold, MBChB, BSc(Hons) Sarah Zhao, MBBS, BSc(Hons) Ruben J. Doyle, MEng, PhD Jonathan R.T. Jeffers, MEng, PhD Oliver R. Boughton, MBBS, BSc(Hons), MRCS, FHEA, PhD
author_facet	Matthew C.A. Arnold, MBChB, BSc(Hons) Sarah Zhao, MBBS, BSc(Hons) Ruben J. Doyle, MEng, PhD Jonathan R.T. Jeffers, MEng, PhD Oliver R. Boughton, MBBS, BSc(Hons), MRCS, FHEA, PhD
author_sort	Matthew C.A. Arnold, MBChB, BSc(Hons)
title	Power-Tool Use in Orthopaedic Surgery
title_short	Power-Tool Use in Orthopaedic Surgery
title_full	Power-Tool Use in Orthopaedic Surgery
title_fullStr	Power-Tool Use in Orthopaedic Surgery
title_full_unstemmed	Power-Tool Use in Orthopaedic Surgery
title_sort	power-tool use in orthopaedic surgery
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/a508d9c47e2a4367ab6648a3bb37a06e
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Power-Tool Use in Orthopaedic Surgery

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