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Dr. Krackow was a stickler for precision, and he was relentlessly thinking about how to make his bone-cutting techniques more reproducible and precise. This chapter on bone-cutting technique and accuracy is inspired from much of the teaching and direction he provided to countless residents and fellows over the years.
Accurate, safe, and efficient use of a power bone saw has become a basic task in modern orthopedic surgery. This section discusses those aspects of equipment and technique that relate to the development of an ability to make accurate and efficient bone cuts. The use of slotted cutting jigs will assist in limiting the error margin for saw cuts and can dictate the thickness of the saw blade. It is useful for the surgeon to understand the basic principles of cutting on an open block versus a slotted jig and the technical considerations for selecting this power tool, which is intimately involved throughout the procedure and has a direct effect on the achievement of the success of the case. For the novice, placing the saw at full power to observe the excursion distance of the tip of the saw is worthwhile to understand the width of the effective cutting arc compared with the physical saw blade. For similar reasons, observation of the distance between the saw’s cutting edge and the handpiece to understand changes in the angle along the length of the sawblade due to lifting off the cutting jig that would affect over- or underresection is a worthwhile exercise.
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