The Thermal Effects of Intramedullary Reaming

Abstract

Because similar temperatures were measured both with and without a tourniquet, the risk of thermal necrosis appears to be related more to the process of intramedullary reaming than to the tourniquet. Higher temperatures were measured with reamer sizes larger than the internal diameter of the intramedullary canal. Increasing the time interval between the passage of successive reamers may allow heat to dissipate and decrease the risk of thermal necrosis. The clinical practice of limited reaming ("ream-to-fit") should minimize the occurrence of this complication.