1. Smaller and lighter
The common theme as technology improves is that everything is
becoming lighter and more ergonomic. Smaller is better in the world
of orthopedic tools. Smaller devices are easier to manage and steril-
ize, they don't take up as much room on the back table and they're
lighter, so you can handle them for longer periods of time without
fatigue.
If I'm doing a rotator cuff repair and have a much lighter handpiece
running my motorized shaver or bur, it makes the case much easier. If
I'm doing internal fixation during a trauma procedure with a plate and
screws, and I have to drill multiple holes, the lighter the drill, the easi-
er it is on me. The smaller tools even have increased speed and torque
now, which lets us complete larger procedures with much less strain
and discomfort.
Thinking back to the reamer I used as a resident in training — it
was a really big, bulky power driver. Now we can run a reamer
down a femoral shaft to nail a femur fracture with a much smaller
device that also offers more torque and more power. The trend is
much more ergonomically friendly to the surgeon.
2. The speeds you need
Many of the handpieces we use now for trauma, especially for small
and medium fracture cases (ankles, wrists, hands and feet, for exam-
ple) let you vary the drill speed with your handpiece. Squeeze the trig-
ger halfway, you get half speed; squeeze it all the way, you get full
speed. And of course you can get every speed in between.
That ability to access a vast range of speeds is extremely helpful. If I
have a long way to drill, I may want to use high speed initially. But if I
get near the end of the bone and don't want to power through it and hit
a nerve or blood vessel behind it, I can slow it down as much as I need
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