Partially adhesive fixation of reconstruction plates at midfacial fractures – an alternative solution to screw fixation?

Abstract

AbstractFor the prognosis and long‐term stability of an implant, for example a hip‐ or knee‐implant, the anchorage to the bone is of critical importance. Normally for this anchorage bone cement is used, which achieves sufficient retention to spongious bone structure. If there is the need for osteosynthesis of midfacial fractures for surgical therapy, in some situations it would be clinically preferable to fix the reconstruction plates without the usual system using screws. This is the aim of the new adhesive fixing technology which is presented in this article. The structure of bone in midface, however, is cortical and such a smooth surface will allow only insufficient retention forces between bone and bone cement. In order to obtain a good adhesion at cortical bone nevertheless, we have to apply a bone bonding agent similar to techniques used in dentistry, which are based on dentin bonding agents, because there are different wetting properties of the hydrophilic bone and the hydrophobic bone cement monomers.Determination of achievable bond strength was done in a tension test ex vivo. Reconstruction plates were fixed with bone cement at bovine bone conditioned with a bone bonding agent developed for this field of application. With bond strengths up to 6 MPa it is assumed that an adhesive fixation of reconstruction plates at cortical bone structure is possible using the developed amphiphilic bone bonding agent.