A Review of the Impacts of Implant Stiffness on Fracture Healing

Abstract

The bone healing process is influenced by various physiological factors. Fracture fixation traditionally relied on rigid metallic implants. However, excessively rigid constructs can lead to complications, necessitating revision surgery. This review focuses on approaches to improve bone healing by introducing adequate interfragmentary movement (IFM) at the fracture site. IFM promotes secondary fracture healing and callus formation. Studies suggest that rigid fixation may impair fracture healing by inhibiting callus formation and causing stress shielding. Titanium alloy locking plates have been shown to be biomechanically superior to stainless steel. Flexible fixation and techniques to regulate implant stiffness are crucial for managing fractures with bridge plating. Materials with a lower Young’s modulus balance biomechanical properties. A novel TiNbSn alloy with a low Young’s modulus has been developed to address stress shielding issues. It is effective in promoting osteosynthesis, bone healing, and superior mechanical properties compared with materials with higher Young’s moduli. The enhanced formation of bone and callus associated with TiNbSn alloy suggests its promise for use in fracture treatment plates. Understanding the biomechanics of fracture healing, optimizing fixation stiffness, and exploring innovative materials like TiNbSn alloys, are crucial for advancing approaches to accelerate and enhance bone healing.

In Silico Investigation of Mandibular Reconstruction: Tissue Differentiation Dynamics with Particulate-Cancellous Bone Marrow Grafts under Varied Bite Forces and Implant Elastic Moduli

“…In contrast, the bone grafts experienced the opposite. It shows a loadsharing phenomenon between implant and bone graft, where the bone graft will gradually aid the implant in bearing the load as its stiffness has increased (Mori et al, 2024). In addition, 35% MBF or M3 had a better load-sharing condition than M4 even though the regeneration was faster during the early days, hence showing the importance of choosing a proper implant to maximize results and prevent stress shielding potential.…”