Get a grip: how hand anthropometrics, grip strength and sex influence power tool use in orthopaedics
Author(s)
Type
Journal Article
Abstract
Introduction:
Female surgeons typically have smaller hands, report negative perceptions and experience pain and discomfort related to instrument design. The aims of this study were to determine whether orthopaedic surgeons receive teaching on power-tool handling, identify power-tool grips used, evaluate whether grip strength and hand anthropometrics influence grip choice, and examine the impact of sex on power tool perceptions.
Methods:
Orthopaedic surgeons (residents and attendings) were surveyed on their power tool perceptions and teaching methods. An objective assessment was carried out which included the categorisation of power tool grips, measurement of grip strength and anthropometric measurements of the hand.
Results:
Forty-six orthopaedic surgeons (12 female, 34 male) were recruited with a response rate of 96%. No orthopaedic surgeon reported formal teaching on power tool handling. Female surgeons reported more negative experiences using the wire driver and drill. Participants demonstrated two variations in power tool posture, with an equal split, determined by the index finger position on either the top or bottom trigger. The index finger bottom position was associated with reduced grip strength, female sex and smaller hand and palm length compared to the index finger top position.
Conclusion
Surgeons with smaller hands or lower grip strength, particularly females, were more likely to use an index finger supported grip, likely as a compensatory strategy. There is the need for early training in power-tool ergonomics and grip techniques, as well as grip strengthening initiatives. The current one size fits all approach is inadequate, manufacturers should ensure designs accommodate a wide range of hand sizes, accounting for palm length and overall hand length, to accommodate all users.
Female surgeons typically have smaller hands, report negative perceptions and experience pain and discomfort related to instrument design. The aims of this study were to determine whether orthopaedic surgeons receive teaching on power-tool handling, identify power-tool grips used, evaluate whether grip strength and hand anthropometrics influence grip choice, and examine the impact of sex on power tool perceptions.
Methods:
Orthopaedic surgeons (residents and attendings) were surveyed on their power tool perceptions and teaching methods. An objective assessment was carried out which included the categorisation of power tool grips, measurement of grip strength and anthropometric measurements of the hand.
Results:
Forty-six orthopaedic surgeons (12 female, 34 male) were recruited with a response rate of 96%. No orthopaedic surgeon reported formal teaching on power tool handling. Female surgeons reported more negative experiences using the wire driver and drill. Participants demonstrated two variations in power tool posture, with an equal split, determined by the index finger position on either the top or bottom trigger. The index finger bottom position was associated with reduced grip strength, female sex and smaller hand and palm length compared to the index finger top position.
Conclusion
Surgeons with smaller hands or lower grip strength, particularly females, were more likely to use an index finger supported grip, likely as a compensatory strategy. There is the need for early training in power-tool ergonomics and grip techniques, as well as grip strengthening initiatives. The current one size fits all approach is inadequate, manufacturers should ensure designs accommodate a wide range of hand sizes, accounting for palm length and overall hand length, to accommodate all users.
Date Issued
2026-04-01
Date Acceptance
2026-03-17
Citation
JBJS Open Access, 2026, 11 (2)
ISSN
2472-7245
Publisher
Wolters Kluwer
Journal / Book Title
JBJS Open Access
Volume
11
Issue
2
Copyright Statement
© 2026 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Identifier
10.2106/JBJS.OA.25.00343
Publication Status
Published
Article Number
25.00343
Date Publish Online
2026-04-01