Force-sensing Drill-through Detection and Automatic Stopping in a Porcine Distal Humerus Model Simulating Pediatric Supracondylar Pinning

Kunzhi Zhu^1,2Chao Feng^1,2,3*Juxiang Huang⁴Gang Chen⁴yuan Pan¹Chaoran Hu¹Yingying Deng¹Yunfeng Xu³Lianyang Lin²

• ¹Guizhou Medical University, Guiyang, China
• ²Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, China
• ³Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
• ⁴Beijing University of Posts and Telecommunications, Beijing, China

Background: Supracondylar humeral fractures are the most common elbow fractures in children and are often treated with closed reduction and percutaneous Kirschner wire (K-wire) fixation. After far-cortex breach, delayed stopping can cause overdrilling and jeopardize adjacent neurovascular structures. We evaluated a force-sensing drill-through stopping system in a porcine humerus model and assessed the effects of feed rate and spindle speed on overdrill depth. Methods: Porcine distal humeri were drilled with a 2.0-mm K-wire introduced through the lateral condyle at ~60° to the humeral longitudinal axis. A six-axis force/torque sensor measured axial force; a transient force drop triggered an automatic stop command. Overdrill depth was the distance the K-wire tip advanced beyond the outer surface of the far cortex. Parameter tests compared feed rates (0.5/1.0/1.5 mm·s⁻¹ at 1200 r·min⁻¹) and spindle speeds (900/1200/1500 r·min⁻¹ at 1.0 mm·s⁻¹). Robotic versus manual drilling was evaluated in paired tests at adjacent, non-interfering sites; manual drilling was performed by a senior pediatric orthopedic surgeon using tactile feedback. Statistical analysis used repeated-measures one-way ANOVA with Geisser–Greenhouse correction and Tukey post hoc tests, and paired t-tests (α = 0.05). Results: Feed rate significantly affected overdrill depth (Geisser–Greenhouse corrected, p = 0.016); 1.5 mm·s⁻¹ produced greater overdrill depth than 0.5 mm·s⁻¹ (Δ = 0.252 mm, adjusted p = 0.0456). Spindle speed had no significant effect (p = 0.900). In paired comparisons, the robotic system reduced overdrilling from 6.60 ± 1.53 mm (manual) to 0.87 ± 0.12 mm (robotic) (mean paired difference 5.73 mm, 95% CI 4.67–6.80; p < 0.0001), an 86.8% reduction. Conclusions: The force-sensing drill-through stopping system limited overdrill depth to approximately 1 mm in a porcine humerus model. Within the tested range of 900–1500 r·min⁻¹ and 0.5–1.5 mm·s⁻¹, higher feed rates produced a modest increase in overdrilling whereas spindle speed had no significant effect. Compared with manual drilling, the system substantially reduced overdrill depth (≈1 mm vs 6.6 mm), suggesting potential safety advantages during percutaneous pinning by limiting overdrilling and thereby increasing the safety margin after far-cortex breakthrough. Clinical studies are warranted to determine whether this translates into fewer neurovascular complications.