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Heat Generation in Bone Cutting-Implications for Thermal Necrosis


 A bunion is a common foot disorder caused by an abnormal outward projection of the joint and inward turning of the toe. Surgery to correct the malformation involves cutting the first metatarsal head, repositioning and setting it; the bone is then left to heal itself over time. A potentially serious by-product of the bone cutting is the frictional heat generated. While the heat susceptibility of individual bone cells varies throughout bone and is difficult to quantify, studies have shown that when injured, bone may not always heal as bone but rather as a fibrous tissue of varying degrees of differentiation. Prolonged heat exposure at or above critical temperatures may also lead to fat and bone cell resorption, a subsequent fat cell degeneration of the tissue, local swelling of cells as well as denaturation of the enzymatic and membrane proteins (Eriksson & Albrektsson, 1983, Li et al, 1999).