Bone void filler materials for augmentation in comminuted fractures: a comprehensive review

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Comminuted fractures pose significant challenges in orthopedic surgery.
• Effective management necessitates bone void fillers to enhance fixation and promote regeneration.
• Current augmentation materials have limitations impacting treatment efficacy.

Purpose of the Study:

• To review bone void filler applications in comminuted fracture management.
• To compare the efficacy and limitations of various bone void filler materials.
• To identify advancements and future directions in biomaterial development for fracture repair.

Main Methods:

• Literature review of bone void filler materials.
• Analysis of autografts, allografts, polymethyl methacrylate (PMMA), and synthetic bone substitutes.
• Evaluation of recent biomaterial modifications and innovations.

Main Results:

• Autografts offer superior osteogenesis but have donor site issues.
• Allografts present immunogenicity risks.
• PMMA provides stability but has cytotoxic concerns.
• Synthetic bone substitutes like calcium phosphate ceramics and bioactive glass show promise but have mechanical limitations.
• Recent advancements focus on composite materials and ion-doped bioceramics.

Conclusions:

• No single ideal bone void filler exists for comminuted fractures.
• A gap remains in materials combining structural integrity with bioactivity.
• Future research should focus on developing load-bearing, bioactive materials for optimized fracture management.