Comparing the accuracy of freehand, fluoroscopically guided and aiming device-assisted drilling in veterinary orthopaedic surgery

Background:
Drilling accuracy is essential in the correct positioning of implants and avoidance of iatrogenic damage to surrounding tissues. The use of augmented drilling methods has been documented as an approach to improving the accuracy of drilling. The aim of this study was to compare the accuracy of two augmented drilling methods (fluoroscopy, aiming device) to free-hand drilling.
Methods:
Three experienced specialist surgeons and three veterinary surgeons without primary orthopaedic experience drilled into synthetic bone towards a target using the three different methods at three different angles (0o, 10o and 20o). The duration of drilling was recorded, and the accuracy of drilling measured using photographs before and after drilling.
Results:
The two augmented methods were more accurate than free-hand drilling in synthetic bone with the aiming device producing the greatest accuracy. Increased angulation of drilling decreased the drilling accuracy. Surgeon experience did not impact on drilling accuracy. Surgeon inexperience and augmented drilling methods both increased the time taken to drill.
Conclusion:
The use of augmented drilling methods improved the accuracy of drilling and surgeons should consider their use when drilling in anatomical regions where the margin of error is small.