Surgical Bone Drilling: A Review

Bone drilling is an important step in orthopedic surgeries for the reconstruction and repair of fractured bones. The main concern in bone drilling is to create holes without causing minimum damage to the bone tissues. It is well reported that high temperature and high force in drilling cause bone thermal necrosis leading to the delayed bone healing and implant failure. In the past, a significant amount of research has been conducted to understand and mitigate the issues in bone drilling. However, the current practice in bone drilling is that medical surgeons still rely on their own experience and feeling, which often causes unwanted damage to the bone. The present paper aims to provide a comprehensive review of surgical bone drilling and impending factors affecting drilling and biological performance of the bone. Current protocols and practices in tackling issues around drilling are discussed and assessed in terms of results obtained in both experimental and computational domains. This pragmatic discussion will signify the importance and challenges ahead in empowering medical surgeons to enable improved surgical outcome. Furthermore, the findings of this extensive review are expected to drive further exploration of new opportunities for developing advanced bone drilling system integrated with intelligent sensors and control technology.