Highly Customizable Bone Fracture Fixation through the Marriage of Composites and Screws

Open reduction internal fixation (ORIF) metal plates provide exceptional support for unstable bone fractures; however, they often result in debilitating soft-tissue adhesions and their rigid shape cannot be easily customized by surgeons. In this work, a surgically feasible ORIF methodology, called AdhFix, is developed combining screws with polymer/hydroxyapatite composites, which are applied shaped situ before being rapidly cured on demand via high-energy visible-light-induced thiol–ene coupling chemistry. The method porcine metacarpals transverse multifragmented fractures, resulting strong stable fixations bending rigidity of 0.28 (0.03) N m2 maximum load break 220 (15) N. Evaluations human cadaver hands proximal phalanx fractures show that AdhFix withstands the forces from finger flexing exercises, while short- long-term vivo rat femur fracture models successfully supports healing without degradation, adverse effects, or adhesions. This procedure represents radical new approach to fixation, grants surgeons unparalleled customizability does not