Performance test of different 3.5 mm drill bits and consequences for orthopaedic surgery.

Introduction: Drilling of bones in orthopaedic and trauma surgery is a common procedure. There are yet no recommendations about which drill bits/coating should be preferred and when to change a used drill bit.

Materials And Methods: In preliminary studies typical "drilling patterns" of surgeons concerning used spindle speed and feeding force were recorded. Different feeding forces were tested and abrasion was analysed using magnification and a scanning electron microscope (SEM). Acquired data were used for programming a friction stir welding machine (FSWM). Four drill bits (a default AISI 440A, a HSS, an AISI 440B and a Zirconium-oxide drill bit) were analysed for abrasive wear after 20/40/60 machine-guided and hand-driven drilled holes. Additionally different drill coatings [diamond-like carbon/grafitic (DLC), titanium nitride/carbide (Ti-N)] were tested.

Results: The mean applied feeding force by surgeons was 45 ± 15.6 Newton (N). HSS bits were still usable after 51 drill holes. Both coated AISI 440A bits showed considerable breakouts of the main cutting edge after 20 hand-driven drilled holes. The coated HSS bit showed very low abrasive wear. The non-coated AISI 440B bit had a similar durability to the HSS bits. The ZrO2 dental drill bit excelled its competitors (no considerable abrasive wear at >100 holes).

Conclusions: If the default AISI 440A drill bit cannot be checked by 20-30× magnification after surgery, it should be replaced after 20 hand-driven drilled holes. Low price coated HSS bits could be a powerful alternative.