Efficiency of Power Versus Hand Screwdriver for Cortical Lag Screw Insertion. Issue 4 (December 2020)

• Record Type: Journal Article
• Authors: Runner, Robert P.; Boissonneault, Adam R.; Bellamy, J. Taylor; Moore, Thomas J.
• Is Part Of: Techniques in orthopaedics. Volume 35:Issue 4(2020)
• Publication Date: 2020-12
• Subjects: lag screws -- screw accuracy -- power screwdriver -- sawbones -- hand screwdriver; Orthopedics -- Periodicals; 617.47
• DOI: 10.1097/BTO.0000000000000345
• Languages: English
• ISSNs: 0885-9698

Abstract

Abstract : Introduction: Limited studies exist on which modality, power or manual instruments, is superior for cortical screw placement. More efficient screw insertion could decrease operative time and reduce overall cost. The purpose of this study is to compare the speed and accuracy of lag screw placement in sawbone models using power and manual screwdrivers. Materials and Methods: A total of 48 orthopedic faculty, orthopedic residents, and medical students participated. Eight stations were tested, each with a different anatomic location (femur/tibia/radius), trajectory (anterior-posterior, lateral-medial, oblique), and screw length (18 to 95 mm). Each station had 1 correct passage and 4 false passages to assess for accuracy. The time required to place the screw in the correct passage using both power and hand screwdrivers was recorded along with the total attempts. Results: There was no significant difference in speed or accuracy of screw placement using power or manual screwdrivers. However, more accurate screw placement was significantly associated with faster insertion time. Level of training and attendance of a basic fracture course were significantly associated with faster insertion times and more accurate insertion when using the power screwdriver on certain stations, but there was no difference using the manual screwdriver. Conclusions: The difference in time between the actual techniques of using power or manual tools is marginal as accuracy is the most important factor for screw insertion efficiency. We propose that surgeons utilize the modality they are more accurate with to prevent misdirected screws and increase efficiency in the operating room.