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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Published on: November 8, 2024

A New Augmentation Method for Improved Screw Fixation in Fragile Bone.

Deepak Bushan Raina¹, Vetra Markevičiūtė², Mindaugas Stravinskas²

¹Department of Clinical Sciences Lund, Orthopedics, The Faculty of Medicine, Lund University, Lund, Sweden.

Frontiers in Bioengineering and Biotechnology

|March 21, 2022

Summary

This study introduces a new method using a calcium sulphate/hydroxyapatite (CaS/HA) biomaterial to improve lag-screw fixation in osteoporotic pertrochanteric fractures. The novel augmentation technique enhances mechanical anchorage, potentially reducing fixation failure in elderly patients.

Keywords:

biomaterial hip fracture implant augmentation implant integration osteoporosis

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Published on: October 23, 2017

Area of Science:

Orthopedic Surgery
Biomaterials Science
Osteoporosis Research

Background:

Pertrochanteric fractures (TF) are common in osteoporotic patients, often leading to fixation failure due to poor bone quality.
Current augmentation methods for bone-implant anchorage in TF lack strong evidence and standardized delivery techniques.
Reinforcing the bone-implant interface is crucial for successful TF fixation in osteoporotic bone.

Purpose of the Study:

To develop and evaluate a novel method for delivering a calcium sulphate/hydroxyapatite (CaS/HA) biomaterial for lag-screw augmentation in TF.
To assess the immediate mechanical anchorage of augmented lag-screws in an osteoporotic bone model.
To demonstrate the feasibility and efficacy of the CaS/HA delivery technique in clinical and ex-vivo settings.

Main Methods:

A novel delivery method for CaS/HA biomaterial at the lag-screw bone-implant interface was developed.
Mechanical testing was performed using an osteoporotic Sawbones model to evaluate lag-screw pull-out strength.
Proof-of-concept studies included in-vivo delivery in TF patients and ex-vivo analysis on donated femoral heads using micro-CT.

Main Results:

CaS/HA augmentation increased lag-screw peak extraction force by fourfold compared to un-augmented screws, comparable to PMMA.
Clinical X-rays confirmed successful, low-pressure injection and spreading of CaS/HA at the bone-implant interface.
Micro-CT imaging of femoral heads showed complete coverage of lag-screw threads by CaS/HA biomaterial.

Conclusions:

A novel and effective method for augmenting lag-screws with CaS/HA biomaterial in pertrochanteric fractures has been presented.
This technique shows potential for significantly improving lag-screw anchorage in osteoporotic bone.
The findings suggest a possible reduction in fracture fixation failure and reoperation rates for fragile patients.