Highly Customizable Bone Fracture Fixation through the Marriage of Composites and ScrewsShow others and affiliations
2021 (English)In: Advanced Functional Materials, ISSN 1616-301X, E-ISSN 1616-3028, Vol. 31, no 41, article id 2105187Article in journal (Refereed) Published
Abstract [en]
Open reduction internal fixation (ORIF) metal plates provide exceptional support for unstable bone fractures; however, they often result in debilitating soft-tissue adhesions and their rigid shape cannot be easily customized by surgeons. In this work, a surgically feasible ORIF methodology, called AdhFix, is developed by combining screws with polymer/hydroxyapatite composites, which are applied and shaped in situ before being rapidly cured on demand via high-energy visible-light-induced thiol–ene coupling chemistry. The method is developed on porcine metacarpals with transverse and multifragmented fractures, resulting in strong and stable fixations with a bending rigidity of 0.28 (0.03) N m2 and a maximum load before break of 220 (15) N. Evaluations on human cadaver hands with proximal phalanx fractures show that AdhFix withstands the forces from finger flexing exercises, while short- and long-term in vivo rat femur fracture models show that AdhFix successfully supports bone healing without degradation, adverse effects, or soft-tissue adhesions. This procedure represents a radical new approach to fracture fixation, which grants surgeons unparalleled customizability and does not result in soft-tissue adhesions. © 2021 The Authors.
Place, publisher, year, edition, pages
John Wiley and Sons Inc , 2021. Vol. 31, no 41, article id 2105187
Keywords [en]
biomaterials, bone fixation, materials engineering, thiol–ene composites, Adhesion, Bone, Fracture fixation, Screws, Tissue, Adverse effect, Bending rigidity, Bone-fracture fixation, Coupling chemistry, Customizability, Internal fixation, New approaches, Visible light induced, Fracture
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:ri:diva-54706DOI: 10.1002/adfm.202105187Scopus ID: 2-s2.0-85108182498OAI: oai:DiVA.org:ri-54706DiVA, id: diva2:1575936
Note
Funding details: Knut och Alice Wallenbergs Stiftelse, 2012.0196, 2017.0300, 2019.0002; Funding text 1: Both V.G. and M.M. are involved in a new SME named Biomedical Bonding AB that aims to aid patients with adhesive fixators as alternative to current commercial metal implants. The company has not influenced, in any kind, the results that are shared with Advanced Functional Materials. The work has been conducted with high ethical consideration and has been academically funded by the Swedish Knut and Alice Wallenberg Foundation.; Funding text 2: D.J.H. performed the analysis of the and materials, the ex vivo analysis of the materials on porcine metacarpal and rib bones and applied the composite to the hand cadaver specimens. V.G. developed the formulation of the and materials and applied the materials to the fractured rat femurs together with D.J.H. J.v.K. and H.A. planned and performed the surgical operations on the human cadaver hands and the rats in the in vivo studies. P.S. performed the three‐point bending and micro‐CT experiments in the in vivo studies. Y.Z. performed the cytotoxicity testing of the material. J.H. planned and was responsible for the overall management of the in vivo studies and the treatment of the rats, as well as running the histology experiments. The manuscript was written by D.J.H. with input from all other authors. M.A. performed surgical operations on the human cadaver hands and oversaw the planning of the cadaver experiment, including all ethical considerations. The project was supervised by M.A. and M.M. The human cadaver hand study was completed with assistance from Alexander Alm and Arthrex Sverige AB, who were paid by Södersjukhuset to procure the specimens and provide the surgical environment. The collection of FT‐Raman data was conducted with assistance from Eric Tyrole and Robert Corkery of the Division of Surface and Corrosion Science at KTH Royal Institute of Technology. This work was generously supported by the Knut and Alice Wallenberg Foundation—KAW (Grant Nos. 2012.0196, 2017.0300, and 2019.0002). A1–A3 B1–B3 A1–A3 B1–B3 B3
2021-06-302021-06-302023-05-22Bibliographically approved