Biomechanics of bone-fracture fixation by stiffness-graded plates in comparison with stainless-steel plates

BACKGROUND: In the internal fixation of fractured bone by means of bone-plates fastened to the bone on its tensile surface, an on-going concern has been the excessive stress-shielding of the bone by the excessively-stiff stainless-steel plate. The compressive stress-shielding at the fracture-interface immediately after fracture-fixation delays callus formation and bone healing. Likewise, the tensile stress-shielding of the layer of the bone underneath the plate can cause osteoporosis and decrease in tensile strength of this layer. METHOD: In order to address this problem, we propose to use stiffness-graded plates. Accordingly, we have computed (by finite-element analysis) the stress distribution in the fractured bone fixed by composite plates, whose stiffness is graded both longitudinally and transversely. RESULTS: It can be seen that the stiffness-graded composite-plates cause less stress-shielding (as an example: at 50% of the healing stage, stress at the fracture interface is compressive in nature i.e. 0.002 GPa for stainless steel plate whereas stiffness graded plates provides tensile stress of 0.002 GPa. This means that stiffness graded plate is allowing the 50% healed bone to participate in loadings). Stiffness-graded plates are more flexible, and hence permit more bending of the fractured bone. This results in higher compressive stresses induced at the fractured faces accelerate bone-healing. On the other hand, away from the fracture interface the reduced stiffness and elastic modulus of the plate causes the neutral axis of the composite structure to be lowered into the bone resulting in the higher tensile stress in the bone-layer underneath the plate, wherein is conducive to the bone preserving its tensile strength. CONCLUSION: Stiffness graded plates (with in-built variable stiffness) are deemed to offer less stress-shielding to the bone, providing higher compressive stress at the fractured interface (to induce accelerated healing) as well as higher tensile stress in the intact portion of the bone (to prevent bone remodeling and osteoporosis)

Hydroxyapatite-TiO2-SiO2-Coated 316L Stainless Steel for Biomedical Application

This study investigated the effectiveness of titania (TiO2) as a reinforcing phase in the hydroxyapatite (HAP) coating and silica (SiO2) single-layer as a bond coat between the TiO2-reinforced hydroxyapatite (TiO2/HAP) top layer and 316L stainless steel (316L SS) substrate on the corrosion resistance and mechanical properties of the underlying 316L SS metallic implant. Single-layer of SiO2 film was first deposited on 316L SS substrate and studied separately. Water contact angle measurements, X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared (FTIR) spectrophotometer analysis were used to evaluate the hydroxyl group reactivity at the SiO2 outer surface. The microstructural and morphological results showed that the reinforcement of HAP coating with TiO2 and SiO2 reduced the crystallite size and the roughness surface. Indeed, the deposition of 50 vol. % TiO2-reinforced hydroxyapatite layer enhanced the hardness and the elastic modulus of the HAP coating, the introduction of SiO2 inner-layer on the surface of the 316L SS allowed the improvement of the bonding strength and the corrosion resistance as confirmed by scratch studies, nanoindentation and cyclic voltammetry tests