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Ti Biocomposite Sinusoid Structure Using Homogenization Schemes
Published in Mohamed Thariq Hameed Sultan, Vishesh Ranjan Kar, Subrata Kumar Panda, Kandaswamy Jayakrishna, Advanced Composite Materials and Structures, 2023
Abhilash Karakoti, Vishesh Ranjan Kar, Karunesh Kumar Shukla
Biocomposites are the prominent replacements of conventional biomaterials in many biomedical applications due to their enhanced material and mechanical properties. For a material to be used for medical implant, it must be biocompatible, corrosion resistant, and should have appropriate strength depending on its use [1]. Out of many nature-inspired materials, functionally graded materials (FGMs) are the advanced composite, which have smooth gradation of material phase from one surface to another [2]. Many structural issues have been raised in biomedical areas in the past, such as high aspect ratio and vulnerability to impact that makes some of the lower limbs prone to fracture. Various types of external and internal fixation devices are used to treat the fracture, such as boneplate/screw, intermedullary rod, external fixator, and screw wires. Some of the major complications of using conventional metals are corrosion, fatigue failure, implant loosening, allergy, and mismatch of stiffness between bone and prosthesis, which can be avoided by using customized FGMs [3–4]. In addition, FGM properties can vary accordingly to match the biomechanical properties of bones at different locations [5]. In recent years, functionally graded biocomposite (FGBC) materials have gained enough attention because of their excellent tailor-made properties, which can enhance the prosthesis performance [6].
Hard Tissue Replacements
Published in Joyce Y. Wong, Joseph D. Bronzino, Biomaterials, 2007
Sang-Hyun Park, Adolfo Llinás, Vijay K. Goel, J.C. Keller
All the internal fixation devices should meet the general requirement of biomaterials, that is, biocompatability, sufficient strength within dimensional constraints, and corrosion resistance. In addition, the device should also provide a suitable mechanical environment for fracture healing. From this perspective, stainless steel, cobalt–chrome alloys, and titanium alloys are most suitable for internal fixation. Detailed mechanical properties of the metallic alloys are discussed in the chapter on metallic biomaterials. Most internal fixation devices persist in the body after the fracture has healed, often causing discomfort and requiring removal. Recently, biodegradable polymers, for example, polylactic acid (PLA) and polyglycolic acid (PGA), have been used to treat minimally loaded fractures, thereby eliminating the need for a second surgery for implant removal. A summary of the basic application of biomaterials in internal fixation is presented in Table 9.1. A description of the principal failure modes of internal fixation devices is presented in Table 9.2.
st Century
Published in Tatiana G. Volova, Yuri S. Vinnik, Ekaterina I. Shishatskaya, Nadejda M. Markelova, Gennady E. Zaikov, Natural-Based Polymers for Biomedical Applications, 2017
Tatiana G. Volova, Yuri S. Vinnik, Ekaterina I. Shishatskaya, Nadejda M. Markelova, Gennady E. Zaikov
In order to improve bone healing, bone fragments are held by screws, nails and plates, which until recently were mainly made of metals or alloys. However, non-degradable internal fixation devices remain in the body after the fracture has healed, often causing discomfort and requiring removal. Surgical removal of internal fixation causes more pain and may induce infection. The use of polymer materials to construct fracture fixation devices has a number of advantages. First, they are lighter; second, they have better contact with tissues; and, third, they need not be removed. Both biostable and biodegradable polymer materials can be used. Devices fabricated from polymers by melt casting are suitable for fixing juxta-articular fractures. Good results were obtained with fixation devices coated with a thick layer (reaching 40% of the coating material) of porous polysulfone. Devices for external and internal fracture fixation fabricated from biodegradable polymers are even more attractive because they are completely replaced by the new bone tissue with time. Rather commonly used fixation devices are nails prepared from degradable polymers and reinforced with methyl methacrylate, nylon fibers, vinylpyrrolidone, etc. These constructs remain sufficiently strong for long periods, up to 6 months and even longer, allowing osteogenesis at the defect site to complete; they are fully resorbed in vivo in 1.5–2.0 years. Coatings for fracture fixation devices may contain antimicrobial agents to prevent infection. Not only polymer and composite materials but also adhesives (glues, cements) are used to join and hold together bone fragments. These substances, in addition to fixing the fragments and filling the fractures, also create an interface between the bone tissue and implant material. Acrylic cements, although insufficiently strong, are the most common adhesives, which have been used for a relatively long time to fix the shafts of the prostheses implanted into the channels of tubular bones.
Finite element analysis of necessity of reduction and selection of internal fixation for valgus-impacted femoral neck fracture
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Yahui Dai, Ming Ni, Bang Dou, Zhiyuan Wang, Yushan Zhang, Xueliang Cui, Wenqian Ma, Tao Qin, Xiaobin Xu, Jiong Mei
Femoral neck fractures are clinically challenging because of the high risk of complications. Internal fixation and arthroplasty are the most commonly used surgical techniques for treating femoral neck fractures, but there is disagreement over which one is superior. Internal fixation can significantly reduce the occurrence of complications than conservative treatment (Xu et al. 2017). However, femoral head necrosis and fracture nonunion cannot be completely avoided with internal fixation, which has complication rates of 15.9–34.6% (Slobogean et al. 2017; Han et al. 2016), especially in elderly patients. But in another study, internal fixation of stable femoral neck fractures achieved good results in patients >65 years of age (Min et al. 2016). Thus, appropriate internal fixation and surgical technique can reduce the risk of complications and improve outcome.
New concept of 3D printed bone clip (polylactic acid/hydroxyapatite/silk composite) for internal fixation of bone fractures
Published in Journal of Biomaterials Science, Polymer Edition, 2018
Yeung Kyu Yeon, Hae Sang Park, Jung Min Lee, Ji Seung Lee, Young Jin Lee, Md. Tipu Sultan, Ye Bin Seo, Ok Joo Lee, Soon Hee Kim, Chan Hum Park
As surgical techniques and implant devices improve, open reduction with internal fixation is evolving as the preferred method for treatment in bone fractures [1]. Currently available devices for the internal fixation of fractures are intramedullary nails (IM nail), plates, and screws [1,2]. The internal fixation has been shown to maintain reduction and provide stability, and lead to an earlier return to function after injury. However, postoperative infection associated with internal fixation devices remains significant complications [1–3]. Postoperative infection can result in delayed unions, prolonged recovery, and need serial surgeries for device removal [1–3]. In addition, internal fixation devices such as IM nail, plates, and screws require drilling in the bone to install devices. This process can lead to secondary fracture, and bone necrosis associated with postoperative infection. As a consequence, the concept of ‘biological internal fixation’ has been developed. The avoidance of biological damages such as precise overlying reduction, application of so many implants and too extensive implant-to-bone contact can reduce the risk of biological complication and improve healing [3,4]. Furthermore, it is technically difficult to fix multiple fragmented bone fractures using such internal fixation devices.
Long bone fractures: treatment patterns and factors contributing to use of intramedullary nailing
Published in Expert Review of Medical Devices, 2020
Abhishek Chitnis, Bidusee Ray, Charisse Sparks, Yuriy Grebenyuk, Mollie Vanderkarr, Chantal E Holy
Current methods used for the surgical treatment of long bone fractures include plate fixation, external fixation, and intramedullary nailing [6]. Despite a lack of consensus regarding the best treatment method for fractures of the femur, tibia, and humerus, open reduction and internal fixation (ORIF) is a popular treatment option [7]. In ORIF, the broken bone is surgically reduced or put back into place. Once the bone is reduced, an internal fixation device (e.g., screw, plate, rod, or pin) is placed on and/or inside the bone to ensure that the bone is stabilized for optimal healing.