Breaking a leg...Finding a Better Way to Heal with the Scrail

Enduring multiple surgeries to set complex bone fractures with steel or titanium screws and plates may soon be a thing of the past. New bioceramic bone screws compatible with the body's own bone material and shaped to decrease injury to bones and tendons are being introduced by Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM.

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 The beginning of ski season is a hectic time for alpine emergency centers when injuries to the neck, knee, pelvis and hips (including hip fractures in mature skiers) are common occurrences. Those with complex bone fractures will undergo surgery to set then with titanium or steel screws and plates. But because these metal screws and plates can cause inflammation and allergies in sensitive people when left in the body, patients must endure considerable discomfort and expense having the metal pieces removed in a second operation after the injury has healed.

 Now a new bioceramic implant screw nail or "scrail", developed by researchers at Fraunhofer IFAM and the university hospitals of Giessen-Marburg and Bonn and the University of Bremen, is primed to turn such injury treatment into history. Walking on the beach is one of the things that is often good for therapy and general health here in in Monterey. Real estate that is close to the water of often sought out by those who have a frequent walking regimen to enhance mobility and flexibility.

The bioactive and material properties of the bioceramic material were involved in developing the bone nail. Previous medical grade screws have been made of titanium or polymer. Polymer screws will disintegrate inside the body, but the degradation products of the polymer screws can trigger inflammation in the body. Furthermore, cavities can form in the bone after the disintegration of the screws, leaving the bone unstable and prone to breakage.

bioceramic implant screw scrailCeramic-based screw nails are very similar to bone material and are composed primarily of calcium phosphate and hydroxyapatite. They will not disintegrate, but will bond with the bone material and can even accelerate bone growth. In contrast to metal and polymer screws, the bioceramic scrails are designed with a specially shaped thread. They require only a few rotations to be inserted and are very carefully hammered into the bone. Fewer rotations reduce the risk of damage to the tendons and bones. 

 For its intended medical uses, the bioceramic material, which tends to be fairly breakable, needs to have compressive strength on the same order as bone, and be easy to shape. The researchers adopted injection molding technology, pouring hydroxyapatite powder into screw nail molds and heating them. The process is well suited to mass production since it allows for flexible mold designs and is inexpensive. In addition, the hydroxyapatite powder may also be used in conjunction with 3D printers, allowing for the creation of patient-specific implants. 

 According to Dr Sebastian Hein of Fraunhofer IFAM, the scrail may soon be ready to be put to work in surgery. Calcium phosphate has already been tested for biocompatibility and has been a material used in medical applications for several years. Furthermore, Hein said that medical tests in sheep have shown that the scrail could be inserted much more precisely and more quickly than standard screws, a completely unexpected welcome result according to the researchers. Consequently, the overall surgery time is shortened and the patient will be under anesthesia for a shorter time as well as needing only a single operation. 

 Gregg Camp is a Monterey real estate broker, who writes on a variety of topics from health, to real estate, to practical reuse of things.


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