ABSTRACT
Some surgeons consider it acceptable to insert threaded fixation pins exclusively with a slow speed (<250 rpm) power drill without pre-drilling pilot holes; however, clinical experience favors a pre-drilling technique. Insertion of fixation pins with a hand chuck without pre-drill ing is unacceptable because the pin ‘wobble’ associated with hand chuck insertion results in bone holes larger than the diameter of the fixation pin and a loose fixation pin-bone interface. Inserting pins with a high speed drill is also unaccept - able because this causes thermal necrosis of the bone, resulting in bone resorp tion and a loose fixation pin-bone interface.
