Thermo-MechanicalmeasurementsofBoneCutting.PDFVIP

CHAPTER 5I TFIERMO.MECHANICAL MEASUREMENTS OF BONE CUTTING: Implications for Thermal Necrosis Debra Millon, B.S. StephanJ. LaPointe, D.P.M., Pb.D. Darren Hffi, Ph.D, INTRODUCTION first metatarsal bone during bunion surgery. Of particular interest is the potential for thermal Temperature elevation in the human first metatarsal (avascular) necrosis. Measurements were made bone during bunion surgery canlead to irreversible using an instrumented cadaver bone to identify the damage to the organic matrix of the bone. As the mechanical conditions under which a critical bone is cut, a large amount of heat is generated temperature would arise in the surrounding bone within the bone. This temperature response can and thermal necrosis would begin. have adverse effects on the ability of the bone to heal itself. Hippocrates was one of the first to MATERIALS AND METHODS recognize this disadvantage in using power tools to cut bone when he recommended to drill slowly, to Thermocouples remove the tool frequently, and plunge it in cold water to cool the tool and prevent the bone from The temperature measurements were performed heating. More recently, microscopic evaluation of using K-type chromei-alumel thermocouples with a sheath diameter. d : 0.508 mm. temperature mea- bone during and after heat application has shown that a pathology, known as thermal necrosis, can suring range of -270 to 7372C (-454 to 2507.6F), occur when bone is exposed to threshold tempefa- approximate sensiiivity of 0.039 mY/C, and accurary tures. Bonfield and Li concluded that temperatures of +0.2C (Omega Engineering, Stamford, CT). This of over 50C (722F) are associated wit