Titanium implants have been the strongest player in the trauma implants industry. It is so difficult to challenge these metallic implants among the orthopedic surgeons and manufacturers. Indeed, we should appreciate titanium for its long time supporting and stabilization of the bone fragments during healing period, by which many fractured bones have been treated. Although, titanium and bone have been significant discrepancies, however, the bone with good or normal mineral density bones (e.g. in younger) could be better accepting or tolerating the tough and rigid titanium compared to bones with low mineral density (e.g. in elderly people).
After 7 years working in development of trauma plating systems (plate and screw) and challenging with various biomechanical, material, clinical, and biological aspects of these implants, I have realized that titanium (and his friend “Stainless Steel”) implants are very tough accompany to the bone and can’t realized this “flexible”, “smart”, “handsome”, and “sensitive” creation. When the bone is fractured, titanium comes to fix it, but can’t be pliable to fulfill all biomechanical, clinical, and biological requirements.
Bone tissue is a smart bioactive structure which is biologically affected by the transferred loading conditions. In fact, bone is smart biomechanical system and its remodeling (bone absorption and formation) is influenced by amount and direction of the loads. When it is fractured, restoration of the bone fragments in anatomical position with minimal fracture gaps is the main challenge of the bone fracture fixation using trauma plating systems. Although the advantages and benefits such as; buttressing and anatomical shaping of the plate, enhanced fragment capturing of the screws, optimum designing of the plate and screw, and other implant design features have been consistently improving, however, biomechanical, clinical, and biological advantages such as; effective micromotion at the fracture gaps, less stress shielding of the bone during fracture healing, less soft tissue irritation, less dislocation of the small fragment under dynamic physiological loading conditions, higher osseointegration of screw at early implantation, and poor osseointegration of screw for implant removal have been less investigated and utilized in development and commercialization of trauma plating systems.
Consideration of these advantages in conjunction with the benefits of implant osseoconductivity and osseoinductivity could allow creation of science and industry breakthroughs in development of trauma plating systems. This was the authors’ enthusiastic hope to write a book which could profoundly review, discuss, and challenge the current biomechanical, material, clinical, and biological aspects of trauma plating systems. On this basis, the book “Trauma Plating Systems” as created and amazingly, along writing of the book, the novel concept “Advance Healing Fixation System (AHealFS)” has been hypothesized and comprehensively disclosed in the book.
With the hope of developing friendlier fixation systems to the bone tissue, let’s invite all orthopedic surgeons, medical device manufacturers, biomedical engineers and researchers, and medical residents and investigators to have a new exciting trip to the“Trauma Plating Systems”.