Additional bone graft

FIGURE 9.1 Two-dimensional distal femur with plate, screws, and bone allograft. A ftacture with butterfly bone separation is shown (butterfly bone segment is the lig)it colored triangle on the left). The plate is shown at the right, with screws through overdrilled holes on the near side and ftill attachment to the cortical bone on the left side. The additional bone graft is on the far left of the bone. 

Bioceramic materials have developed into a very powerful driver of advanced ceramics research and development. For many years bioceramics, both bioinert materials such as alumina, zirconia and, to a limited extent titania (Lindgren et al., 2009), and bioconductive materials such as hydroxyapatite, tricalcium phosphate and calcium phosphate cements, have been used successfully in dinical practice. In addition, applications continue to emerge that use biomaterials for medical devices. An excellent account of the wide range of bioceramics available today has recently been produced by Kokubo (2008), in which issues of the significance of the structure, mechanical properties and biological interaction of biomaterials are discussed, and their clinical applications in joint replacement, bone grafts, tissue engineering, and dentistry are reviewed. The type and consequences of cellular responses to a variety of today s biomaterials have been detailed in recent books (Di Silvio, 2008 Basu et al., 2009 Planell et al., 2009). 

In addition to drug delivery, collagen has been used in applications in the medical-pharmaceutical interface, including tissue engineering (i.e., composites of collagen with hydroxyapatite and tricalcium phosphate in bone grafts or as artificial valve and vessel substitutes) [417] and surgical sutures [418]. 

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