1 - General Concepts

Abstract

Various aspects of biological, biomechanical, material, and clinical challenges are examined in an investigation of bone fracture fixation. Indeed, these factors are integral to the effective treatment of the bone fractures. Biologically, bone fracture is healed in couple of weeks or months and bone healing is progresses in main stages including hematoma, absorption of defective bone cells, soft callus formation, hard callus formation, and lamellar bone formation. In each stage, fracture fixation is crucial to maintain stability, and biomechanical aspects of fracture fixation play important role in fracture nonunion or malunion. In view of material concerns, the good biocompatibility of the implant material is the first challenge. Inherent mechanical, physical, and chemical characteristics of the material affect the long-term usability of the implant during fracture healing. Bioinertness, biodegradability, and bioactivity of the material in body fluid and in contact with bone tissue are also studied in development of the fracture fixation implants. Successful fracture healing is when the bone fragments are united anatomically with no misalignment. This would necessitate careful consideration of clinical aspects of fracture fixation. Preoperative study of the fracture, intraoperative reduction of bone fragments, proper implant selection, soft tissue preservation and treatment, and post-operative treatment plan are some clinical considerations that would significantly affect the extent of pain and functionality at the fracture site during healing period and after union of the fracture. All these various aspects of the fracture fixation are affected by each other; therefore, many biomechanical and clinical investigations are carried out to evaluate and clarify the effect of these factors on the efficacy of the bone fracture fixation. In this chapter, some general biological, biomechanical, material, and clinical terms utilized in bone plating fixation are reviewed and further details are extensively presented and discussed in the next chapters.