Medical exhibitions always have a special place for professionals in the medical device and equipment industry. Such expos have a purpose, they are not organized just like that. This is why manufacturers, distributors, dealers, and suppliers actively take part in such medical trade fairs.
Especially talking about the healthcare industry, these medical exhibitions provide a lot of opportunities in terms of new clients, brand awareness, knowledge about challenges & latest technologies, and much more. Numerous medical expos are organized every year and many are a huge success. That’s all because of the opportunities they offer to exhibitors and participants. In this post, we are going to talk about one such expo that is highly successful. We are talking about FIME Trade Show. Let us see it in detail.
What is FIME?
Abbreviated for Florida International Medical Expo, FIME is known to be a leading event for the Americas in the medical equipment and device sector. Organized every year, the FIME Expo brings the healthcare community together to address challenges, talk about the latest technologies, and discuss case studies for the advancement of the healthcare industry.
This year, the FIME Medical Exhibition will take place at Miami Beach Convention Center from 27 to 29 July 2022. Just like every year, FIME is going to experience a footfall of thousands of medical equipment & device manufacturers, distributors, suppliers, and dealers.
The FIME also provides the opportunity to over 700 exhibitors to find new businesses and connect with industry experts. Exhibitors from over 45 countries take part in the expo and thousands of healthcare industry professionals visit the show.
How FIME Miami is Helpful for Visitors?
FIME is not only a platform where exhibitors find business opportunities but it also has a lot for visitors. They can explore new products & supplies, experience the latest technologies, connect with new suppliers, and more importantly get knowledge about the global medical equipment and device market. Thus, it won’t be wrong to say that FIME medical has something for everyone who attends the expo. This is why it is known as a leading medical exhibition in the Americas for the healthcare industry.
Above all, the FIME trade show also invites keynote speakers from across the globe to share their experiences and discuss case studies for the advancement and improvement of the future of the healthcare industry. So, we can also say that this medical exhibition is also a great platform to gain knowledge about the healthcare industry. Overall, the FIME Medical Trade Show Miami is a complete package for the medical industry to gather as much information as it can for the betterment of individual businesses and the whole industry.
What’s New in FIME Show 2022?
The FIME medical expo never fails to surprise visitors. In 2022, the 31st edition of the expo has announced a brand-new transformation zone. Now, you must be wondering what this is all about? Don’t worry, we will see what this transformation zone is.
The goal of this healthcare transformation zone will be to encourage new medical start-ups and boost their confidence. This new addition at the FIME will feature innovative talks and it boasts prizes worth over USD 20,000 that will be given to the most innovative start-ups.
Besides all this, there will also be healthcare transformation talks where industry experts will talk about the latest insights, discoveries, and also predictions of the future. Along with this, there will be a lot of things that visitors will experience related to the combination of science and technology at the expo.
Siora Surgicals and the FIME
There is a strong connection between Siora Surgicals Pvt. Ltd. and the FIME Medical Expo. Siora is a renowned orthopedic device manufacturer based in India, and it is a regular exhibitor at the show. Siora Surgicals is participating in the show for years and it has not only helped the company gain new businesses but also gain knowledge about the latest and trending insights of the healthcare sector. In FIME Medical Expo 2022, booth G36 is where Siora is going to exhibit and it expects to have a great outing this year as well.
Just like every year, Siora is also going to showcase its innovative solutions for the orthopedic sector in 2022. To experience what Siora has for you, we invite you to visit our booth at the FIME conference and clear your queries with our industry experts.
The demand for orthopedic implants is high across the globe and this is because of the number of cases of broken bones that are reported annually. In the last 3-4 decades, this field has grown to a great extent and so does the quality of orthopedic devices. The advancements in the industry have led to improvements in trauma implants and they are now much more effective when compared to the ones used earlier.
To reduce the rejection rate of implants and deliver improved post-surgical outcomes, different types of coatings are applied. One of the most commonly used coatings is ‘Hydroxyapatite Coating.’ In this post, our sole focus will be on discussing what hydroxyapatite (HA) coating is and how it helps improve the performance of orthopedic devices.
Why Coatings Are Important on Orthopedic Implants?
Not all metals, ceramics, and polymers are compatible to manufacture trauma implants as certain considerations need to be met. After years of studies and research, only some materials have been approved to produce orthopedic devices.
It is a serious matter, as the implants are applied inside our body, and hence, the materials used must not interfere with the normal functioning of our body, and neither they should produce any adverse reactions. In simpler terms, we should say that metals or non-metals used to manufacture implants must be biocompatible as they need to stay for years inside a human body. Besides this, they must also possess excellent weight and impact resistance along with high durability.
Now, it is not possible to get all these properties in a single biomaterial thus, coatings are applied to get the required characteristics in the implants. Coatings not only improve the structural characteristics but also help in better bone integration.
The two most applied coatings on the implants are porous titanium coating and hydroxyapatite (HA) coating. These coatings are applied in layers depending upon the required thickness and porosity.
What is Hydroxyapatite?
You would be surprised to know that hydroxyapatite is a naturally occurring compound that is also present in bones and teeth, in fact, it is a primary inorganic component in them. In our bones, HA is present in its carbonated form in large amounts. Besides this, the bones of the mammals, fishes, shrimps, seashells, and eggshells of birds also comprise HA. Above all, rocks like sea corals and limestone also have hydroxyapatite.
The HA coating applied on implants is derived from the above-mentioned sources and can also be synthesized chemically. This coating plays a crucial role in enhancing the properties of orthopaedic devices.
What is the Importance of Hydroxyapatite Coating?
Studies have confirmed that HA coating on implants has shown excellent results for bone repair, bone regrowth, and successful integration. HA is not new to this use; it is something that is being used for hundreds of years for bone repair and to rebuild damaged or missing parts in the bone grafts.
Being a component of our bones, hydroxyapatite shows positive reactions with our bones when an HA-coated implant is placed inside our body. It is not only compatible with the body but is also very stable, hence, it will not break easily. Hydroxyapatite possesses excellent osteoconductive properties plus, it is bioactive as well.
HA is known to properly bind with the bones and help regenerate bone tissues to deliver excellent results. Thus, applying HA coating on the implants helps reduce implant rejection or failure chances while ensuring improved and successful implant integration. Here, it is always important to ensure that the HA coating is applied properly.
How Hydroxyapatite Functions when Applied on Implants?
Hydroxyapatite is known to have innate chemical similarities to the bone, thus, when it is coated on implants, it helps the natural bone to fix to the implant by providing an osteophilic surface. HA is also known to have good osteoinductive properties and hence, it enhances the functioning of bone-forming cells osteoblasts.
For an implant to function properly, it is necessary that the surrounding bones must accept and integrate it into the body. Here, HA coating ensures that the implant will excellently get integrated into the body in a maximum of cases.
Now, you might be thinking that when hydroxyapatite is such a great compound then why we shouldn’t make implants using it instead of coating it over other metals. So, implants made entirely from HA are not strong enough to bear the weight of the body, thus, this idea is dropped. Implants made from titanium are considered best owing to their biocompatibility and good mechanical properties. To provide good osteointegration properties, HA coating is applied to them.
What Are the Factors that Need to be Considered with HA Coating?
There are many ways by which HA coating could be applied on implants like plasma spray, electrochemical deposition, dip coating, etc. Besides this, the accuracy at which the coating is applied is the key. Below mentioned are factors to be considered while applying HA coating:
When it comes to the thickness of the coating, then it should not be too thin and too thick. This is because a thin coating might not show the expected reaction with the bone whereas a thick coating might result in mechanical failure. So, the ideal thickness of HA coating must be there to deliver the expected results.
Now, we did talk about ideal thickness but, another point to be noticed here is a uniform thickness. Throughout the implant, the same thickness must be there as unevenness could hamper the performance.
The quality of the growth of the bone and formation of blood vessels somehow depends upon the surface texture of the coating applied on the implant. It is measured as the roughness and porosity on the implant’s surface.
Scientists are creating HA with antibacterial properties as an infection is found to be one of the most common reasons for implant failure. Thus, if you would be able to provide antibacterial HA coating on orthopedic implants, the rejection rate due to infection will also reduce.
Siora Surgicals Pvt. Ltd. is a CE-certified and experienced manufacturer of an extensive range of orthopedic implants in India. It also manufactures HA coated implants like Tapered Schanz pins & Radial Head Prosthesis. With over 30 years of experience, the company specializes in producing all kinds of implants that come under different categories and sizes. Siora also exports its ISO 13485:2016 certified implants to clients based in different countries across the globe. It also offers HA-coated orthopedic implants as per the client’s request.
It doesn’t matter what type of disease or injury a person suffers from, the body’s response towards that condition is always critical. There is no doubt that effective treatment is required for healing but, if the body does not respond in the way it should, the condition could become worse.
When we talk about fractures, the similar is the case. The doctor may perform surgery to apply Orthopedic implants or apply a cast or a splint to stabilize the fractured bone fragments, but the response of the body will decide how much time it will take to bring back the normal functioning of the fractured site and the effectiveness of the treatment.
We are here to discuss in detail how our body reacts to fractures and how it helps the bone heal after the treatment.
We must say that our body is magical, as it quickly responds to any injury or disease that occurs to minimize its effects till the time right treatment is taken. Even after the treatment, it supports fixing the condition as soon as possible in a better way. In some people, the response of the body is not normal, or we should say the response is not as it should be. In such cases, significant health complications may be seen other than ongoing conditions. Let us now move to our topic starting with the basics.
Composition of the Bone
Our bone is composed of two types of tissues:
- Compact bone
- Cancellous bone
Compact Bone (Cortical Bone)
It is the outer layer of the bone, which is hard, strong, dense, & durable. Around 80% of bone mass in adults is compact bone.
Also known as trabecular or spongy bone, it is light, flexible, and less dense when compared to compact bone.
Besides these, the type of cells found in our bones include:
All these cells have different functions that help in keeping bones healthy.
What Happens When a Fracture Occurs?
When a bone breaks, intense pain is obvious, and when the body starts acting against the break, swelling around the injured area is noticed. Bones also contain blood vessels, and they get damaged in case of fracture causing hematoma. The blood clots form in the gap created between the broken bone pieces.
When the inflammation occurs, the immune system of our body activates stem cells in the surrounding tissues, bone marrow, and blood. They are guided towards the fracture site to start the healing process. Now, when it comes to the healing of the bone, these cells trigger two different pathways including:
- Cartilage Formation
- Bone Formation
How Bone Repairs?
The body works according to the severity of the fracture, and the healing process is known to start within a few hours of injury. Let us see step by step how this occurs:
Step – 1
When a fracture occurs, blood clots start to form on the fracture site, and that results in swelling. Here, the immune system of our body gets activated, and it triggers stem cells to migrate to the fracture site. It also activates special types of cells that eliminate germs and small bone fragments.
Step – 2
After 2-3 weeks, a soft callus is formed around the broken bone. This is also a stage where the blood clot is replaced by collagen. One of the key reasons why a cast is applied is to maintain the stability of the bone that is being healed. This is because if the fractured bone gets displaced during the healing process, the condition could become worse.
Step – 3
Around 2 weeks after soft callus formation, the body starts producing hard callus which is more stable & stronger. Cells involved in the formation of hard callus are osteoblasts. These cells are involved in the formation of new bone. This stage generally lasts around 6-12 weeks after the fracture.
Step – 4
This is the stage where bone remodeling occurs and that is initiated by osteoclasts. These cells reshape the bone by removing any extra bone that is formed during healing and ensures that the newly formed bone takes its original shape. At this stage, the person generally starts doing physical activity, and this actually helps in strengthening the newly formed bone. Slowly, the person can also return to normal activities. You might be surprised to know that the remodeling process could continue for long even after the person returns to his/her normal life.
How Much Time Does It take for a Bone to Heal?
In most cases, the average healing time of a fracture is about 6 to 8 weeks. Although, the time required generally depends upon the severity of the fracture. If the bone break is severe or complicated, complete healing may take even months. Besides this, the age of the person also plays an important role in deciding the time required for a fracture to heal. For example, healing might require a longer time in the elderly when compared to in adults. Some other factors that could affect healing include:
- Lack of physical therapy or exercise as suggested by the doctor
What is the Role of Surgeons in Ensuring Proper Healing of a Fracture?
Now, this is a good question. When the body responds to a fracture and helps it heal then what is the role of surgeons? Let us see why surgeons are important in ensuring the correct healing of a fracture.
When a fracture occurs, broken bone fragments could move in any direction, and sometimes, they even come out of the skin. For a broken bone to heal, the fractured pieces need to be in a correct anatomical position and close to each other. This will not happen on its own, and that’s where the role of surgeons comes in.
Depending upon the diagnosis of the fracture, the surgeon decides whether the broken bones require surgery for realignment, or it could be done without that. If surgery is not required, the surgeon might perform closed reduction to realign bones if needed, and then apply a cast. Sometimes, the application of a splint is also helpful.
While on the other hand, if it is not possible to realign broken ones with closed reduction, or the fracture is complicated, surgery will be recommended. It is done either under general or local anesthesia. An incision is made during the surgery to expose the fractured bone, and pieces are then realigned in their true anatomical position using Orthopedic Trauma Implants like metal plates, screws, and pins.
Once bones are realigned, the proper healing process starts.
So, this is how a broken bone heals and helps the person get back to his/her normal life. We hope it would have been helpful to you.
Siora Surgicals Pvt. Ltd. is a CE-certified manufacturer of an extensive range of orthopedic devices including Hand Locking System, SCRUCAN Cannulated Compression System, and ILIZARC Ring Ex-Fix System. The company is operating for over 3 decades, and most of the distributors & orthopedic surgeons are connected with Siora for about 25 years. This is the kind of trust the company has built over the years. Siora also provides high-quality OEM/contract manufacturing services.
Bones provide structure to our body, anchor muscles, store calcium, and protect vital organs. There are so many roles that bones play, and all are important to ensure good health. Now, when an injury or disease occurs to the bone(s), the movements of the affected area in an individual become limited. Sometimes, the condition is severe enough to require surgical intervention for the treatment.
Bones could also get affected because of other health conditions occurring in our bodies. One such condition that occurs includes bone metastasis, and this will be our point of discussion in the post. Bone metastasis occurs in people who are suffering from certain types of cancers. Let us talk about that in detail.
Bone Metastasis – An Overview
Also known as osseous metastatic disease, bone metastasis is the condition that occurs when a primary tumor invades the bones. In other words, this condition arises when cancer cells break from their original position and starts growing on the bone. Any bone could get affected by this condition as you never know where the broken cancerous cells will fall. Epithelial tumors cause bone metastasis by creating a solid mass inside the bone.
Many problems arise when tumor cells affect bones, the most common being a pain in the bone and fractures. The cancers that have the highest chances of causing bone metastasis to include:
- Breast cancer
- Prostate cancer
- Lung cancer
- Thyroid cancer
- Kidney cancer
- Ovarian cancer
Now, when it comes to the sites where bone metastasis is most seen, then the spine is at the top. Other sites may include:
Pain and broken bones are the common symptoms associated with the condition for which treatment is provided, but in most severe cases, the condition becomes incurable.
As per the studies, 2 types of cells maintain our bones namely:
Osteoblasts – They are responsible for the formation of new bones
Osteoclasts – They are responsible for the breakdown of old bones
Optimum functioning of both these cells is required to maintain strong and healthy bones. This is because both growth of new bone cells and the breakdown of older ones are necessary, and hence, osteoblasts and osteoclasts work in tandem.
Now, when tumor cells affect bones, the working of osteoblasts & osteoclasts gets affected as well. The rate at which they work either becomes high or low, and both situations badly affect bone health. This makes bones prone to getting fractured easily. Few other problems caused by the condition include:
If the spine is affected by bone metastasis, the spinal cord may be pressed down. If such a condition occurs, nerve damage will be on the cards. While on the other hand, if left untreated or delayed treatment is there, paralysis may be seen.
Another problem that may arise is hypercalcemia, and this occurs due to the release of excessive calcium in blood because of too much dissolving of bone.
Symptoms Associated with Bone Metastasis
Some of the common symptoms associated with the condition include:
- Pain in the bones
- Urinary incontinence
- Loss of bowel control
- Weakness in legs or arms
- Low blood cell count
Sometimes, bone metastasis is confused with bone cancer, but both conditions are different. Bone cancer is the condition where tumor cells originate in the bone itself. While on the other hand, bone metastasis is where tumor cells from a different cancerous site in our body spread to any bone and start multiplying there.
Diagnosis of Bone Metastasis
The diagnosis of the condition often starts with a complete medical history check and physical examination of the patient. During the diagnosis of bone metastasis, the doctor would also want to know any past incidences of cancer. Besides this, imaging tests also play an important role in confirming the exact location and severity of the condition. The tests ordered may include:
- CT scans
- Bone scans
- MRI scans
- Blood tests
Above all, a biopsy may be performed in certain cases to confirm whether the affected bone is a result of bone metastasis or a sign of primary bone cancer.
Treatment of Bone Metastasis
After proper diagnosis of the condition, the doctor decides which treatment methods will be feasible and which one will be the best. This totally depends upon the source of cancer cells, the location of the affected site, and the severity of the condition. Some of the common treatment procedures include:
Radiation therapy is given to slow down the growth of tumor cells multiplying on the bone. Different types of radiation therapy procedures that are used include:
Local Field Radiation – During this therapy, the doctor directs radiation at the tumor and surrounding tissues. This process is known to relieve pain in most cases.
Hemi-Body Radiation – This type of therapy is preferred when the person is suffering from multiple bone metastasis. In this case, radiation is directed at a large part of the body.
Radioisotope Therapy – In this case, venous administration of radioactive medicine is done.
Medication plays an important role in the treatment of bone metastasis, and here, one or more medicines may be prescribed by the doctor depending upon the condition of the patient. The medicines prescribed may include:
- Bone-building drugs to reduce damage to bones
- Chemotherapy to kill or reduce the size of cancer cells
- Hormone therapy
When the condition is severe or other treatment methods did not deliver expected results, surgery may be performed. This is also an option in case of fractures, or the chances of fracture anytime soon are there. In certain cases, surgery is also performed to remove the tumor.
During surgical intervention, orthopedic fixation devices like metal implant plates and screws are also used to stabilize the affected bone and ensure its correct placement while it heals. The type of orthopedic implant used will depend upon the affected location.
Siora Surgicals Pvt. Ltd. is one of the oldest manufacturers of international standard quality orthopedic devices in India. The company has numerous global clients, and it exports its entire range to different parts of the world. Siora is also known to be a reliable OEM/contract manufacturing service provider.
Also known as an interlocking nail or intramedullary nail, an intramedullary rod is one of the most used orthopedic implants for the treatment of long bone fractures, for example, femur and tibia fractures. It is used by inserting into the medullary cavity of the bone to stabilize and align the fracture. These rods are known to be designed to stay in the body forever. One of the reasons why the use of IM rods is preferred rather than other methods of fixation is that they can share the load with the bone rather than only providing support.
History of Intramedullary Rods
Intramedullary rods are known to be used for the first time in World War II (1939) to fix femur fractures in soldiers. Gerhard Kuntscher, a German surgeon is the one who used intramedullary nailing for the first time. The use of IM nails for fracture fixation helps in quick recovery when compared to traditional ways like plaster application or traction. This became a huge advantage for soldiers during World War II.
Why are IM Nails known as Locking Nails?
The cross-sectional structure of IM nails was ‘V’ or triangular-shaped earlier and later, it was changed to the presently used clover-shape to make it more stable. Besides this, stainless steel was the choice of material for the manufacturing of IM nails but, with time, titanium became the preference for having better biocompatibility and lower mechanical failure rates.
The design of Intramedullary rods that were used earlier had some issues with preventing collapse or rotation in unstable fractures. This is where the concept of “locking” the nails came in. The use of bolts was introduced to lock the nails from each end to prevent rotation of the fragments. That is the type of intramedullary interlocking nails we are using these days.
Bone Healing and Intramedullary Rods
There is a misconception in some of our minds that the use of implants like IM rods speeds up the healing process. But this is not the case, implants do not impact the way our body heals bones though, they do provide the stability to broken bone fragments. Implants are designed to hold fractured bone fragments into their correct alignment.
If we talk about implants like IM nails, then they are designed to carry the load of the body along with stabilizing the fracture. This is why people having IM nails used to fix long bone fractures tend to easily place weight on the extremity sooner than to wait for complete healing of the bone.
Early mobilization prevents joint stiffness which is a common sequela after plaster. While on the other hand, early load-bearing improves the recovery of post-traumatic muscle atonia and also improves the proprioception of the limb involved.
Uses of Intramedullary Rods
Broken long bones are often treated with intramedullary nailing. The rod is inserted into the medullary cavity by making a small incision either at the knee or hip. Once inserted, the rod is locked at both ends using orthopedic screws to prevent any rotation of the fragments. Locking of the nail ensures its proper positioning until the bone heals. When compared to using a cast or external fixation, an IM rod ensures better positioning.
Femoral shaft fractures and shinbone fractures are the ones for which IM interlocking nails are used. Intramedullary nailing is found to be effective in the treatment of the above-mentioned fractures as the implant allows full-length fixation.
Intramedullary nails are most commonly made using titanium for being highly biocompatible and showing good biochemical inertness. Besides this, they are also available in different lengths and diameters. The size of the IM nail to be used is chosen according to the age and height of the patient.
Above all, the use of intramedullary nails is also there to fix and provide support to the bone after tumor removal in the case of metastatic bone disease. IM rods can also provide support to the bones that are at high risk for fractures. Intramedullary rods may also be used for preventing fractures and progressive deformity of long bones in people suffering from osteogenesis imperfecta (brittle bone disease), a genetic disorder.
Is There Any Damage to Bone Marrow After Inserting IM Rod?
Yes, of course! Insertion of rod or nail into the medullary cavity damages the bone marrow of that bone. But the point to be noticed here is that intramedullary nailing does not impact the ability of red blood cells and immune cells formation. Plus, if the rod is removed after complete healing of the bone, bone marrow present in that bone could regenerate itself. If the nail needs to be removed, it is generally done a year after the surgery or may depend upon the recovery speed of the patient.
Siora Surgicals Pvt. Ltd. is crowned as one of the best manufacturers of a huge range of orthopedic devices including Intramedullary Nails. The company uses ISO standard titanium and stainless steel for the manufacturing of implants to meet the international guidelines. Siora is an ISO 13485:2016 and ISO 9001:2015 certified company having an FDA-India approved manufacturing unit established in Sonipat, Haryana. The quality and effectiveness of implants produced by Siora are praised by the top orthopedic surgeons across the globe. To avoid any biological contamination and maintain the highest quality standards, the packaging of implants by Siora is done in an ISO class 7 (10,000) cleanroom environment. Siora Surgicals is also open to providing quality OEM/contract manufacturing services.
The use of orthopedic devices for the fixation of fractures is new as it is being practiced for ages. The things that have changed are the quality and effectiveness along with the materials they are made from. One of the oldest orthopedic implants that are being used is the bone screw.
Archimedes of Syracuse is known to be the father of the screw who invented it in the third century BCE. If we talk about the use of orthopedic screws, then they were used for the first time in the 19th century (1850) by the French surgeons Cucel and Rigaud. The surgery was performed to reduce the olecranon fracture by internal fixation. This was the first-ever internal fixation procedure. During this surgery, the French surgeons used 2 transcutaneous screws.
Advancements in the field of orthopedics have led to the development of different types of orthopedic screws that are being used depending upon the type of orthopedic condition to be fixed. In this post, we will see different types of bone screws that are being used during orthopedic surgeries along with their other details.
What Are Orthopedic Bone Screws?
Orthopedic bone screws are metal-made hardware devices that are specially manufactured to be used inside a human body for the fixation of fractures. They are most commonly made of stainless steel and titanium as these metal alloys show better biochemical compatibility and inertness.
Screws used in orthopedic surgeries play a vital role in ensuring better healing of the fractured bone as the screws provide enough compression while reducing the gap between bone fragments. They are also known to reduce stress on the implants thus, helping them do their job properly. Depending upon the location and seriousness of the fracture, screws can either be used alone or in synchronization with other orthopedic implants.
Parts of Orthopedic Bone Screws
Before we move on to the different types of screws during orthopedic surgeries, let us have a look at the parts of bone screws:
The top flattened part of the screw is known as the head and it is mainly used to insert the screw inside the bone. The head configuration could be different and based on that, the screwdriver is used.
It is the distance between the head of the screw to its tip. Different screw lengths are used for the fixation of different types of fractures.
When it comes to measuring the diameter of an orthopedic screw, special care must be taken. This is because there are two types of diameters in orthopedic screws:
- The outer diameter is measured as a total thickness from one end of the thread to other
- The inner or the root diameter is the narrowest diameter which is measured from across the base of the thread.
Note – It is important to make sure that the diameter of the pilot hole must be the same as the inner diameter before screw insertion.
Pitch is the distance an orthopedic screw travels with each 360-degree turn.
The tip is the end of the screw present opposite to the head. The tip of the orthopedic screw can be of three types including non-tapping, self-tapping, and self-drilling.
Different Types of Orthopedic Bone Screws
The orthopedic bone screws can be classified based on the type of bone in which they will be used and also the location. Let us have a look at common types of bone screws used during orthopedic surgeries:
Cortical bones account for more than 80% of bone mass in the human body. These types of orthopedic screws are designed specifically to be used for hard bone tissues/cortical bones. Cortical screws are designed to have threads and this means that their pitch will be small. They are fully threaded screws but can also be availed in partially threaded configuration.
Cancellous screws are made to be used in spongy bones that are a bit softer. So, it is important to use screws that deliver better results during orthopedic surgeries. When compared to cortex screws, they are longer and have a larger pitch. Another factor that differentiates cancellous orthopedic screws from cortex screws is that the former ones have deep threads. They can be availed in both partially and completely threaded configurations.
Pedicle screws are designed to be used for spinal fusion or spinal fractures. These types of bone screws are threaded and have a mobile head. Just like other types of screws, pedicle bone screws can also be availed in different sizes. They are used to treat trauma or deformity occurring in the spine. These screws can be placed in the lumbar spine, thoracic vertebra, and sacral vertebra.
Cannulated screws are used for the fixation of different types of fracture patterns and also to pass a guidewire for the correct placement of the screws. They are designed to have a hollow shaft to facilitate guidewire for better alignment before drilling. Cannulated screws help surgeons avoid drilling multiple holes during fracture fixation. These types of orthopedic screws can be availed in cancellous and cortical configurations.
They are headless screws and are most commonly used for the internal fixation of bones involving joint cartilages. Some of the most common uses of these types of screws are scaphoid, radial head, capitellum, and osteochondral fractures.
These types of screws are most commonly used for the fixation of small fragments in the cancellous bone. Interfragmental compression of bone plates is what malleolar screws are best applied for. They are known for having a smooth shaft and are available in the partially threaded configuration. Malleolar screws are used for the fixation of ankle fractures.
Materials Used for the Manufacturing of Orthopedic Bone Screws
Orthopedic bone screws are made using materials that are biocompatible and biochemically inert. Below-mentioned is the materials used for the manufacturing of bone screws:
Stainless steel is the most commonly used metal alloy for the manufacturing of bone screws. Screws made from this metal can be used for both cancellous and cortex bones.
The chances of infection caused by titanium screws are lesser when compared to the ones made from stainless steel. Titanium-made orthopedic screws are known to be best for the treatment of mandibular fractures.
Besides metal alloys, orthopedic screws are also made using bio-absorbable materials including polylactic acid, polyglycolic acid, and poly-L-lactic acid. These types of bone screws need not be removed later on as they are absorbed by the body.
Siora Surgicals Pvt. Ltd. is an experienced manufacturer of all types of orthopedic bone screws that are used for the fixation of different types of fractures. The company uses ISO-grade titanium and stainless steel for the manufacturing of its implants. Siora is an ISO 9001:2015 and ISO 13485:2016 certified company having an FDA-approved manufacturing unit in the RAI District, Sonipat, Haryana (India). The company is also open to providing OEM/contract manufacturing services.
Clavicle fractures are very common and comprise 2.6% to 5% of all fractures in adults, with midshaft injuries accounting for almost 75% of all fracture types. Clavicle fractures typically occur when an axial load is applied to the bone, generally in the form of a sudden point load to the apex of the shoulder. When these fractures displace, the proximal fragment is usually pulled superiorly by the sternocleidomastoid muscle while the distal fragment is pulled laterally by the weight of the arm. Most minimally displaced clavicular or nondisplaced fractures can be managed non-surgically simply by placing the arm in a sling. In these instances, the malunion and nonunion rates are very low.
However, when midshaft clavicular fractures present with complete displacement or significant shortening, the risk of nonunion is significantly higher with conservative management. Surgical decision making is a matter of debate. Currently, the only absolute indications for surgical treatment of clavicular fractures include open fractures and injuries associated with evolving skin compromise. Relative indications for internal fixation and open reduction of midshaft clavicular fractures include injuries with 15 to 20 mm of shortening, fractures with significant comminution, completely displaced fractures, floating shoulder injuries that involve a concomitant glenoid neck fracture, painful non-unions, and midshaft clavicular fractures in some multisystem trauma cases.
Depending on fracture morphology, either open or closed reduction and intramedullary orthopedic pin fixation or open reduction and bone plate fixation can be performed and these quality implants can be supplied by Orthopedic implants Manufacturers. Biochemically, both methods provide similar repair strength for middle-third clavicle fractures. After hardware removal, clavicles previously treated with intramedullary fixation were shown to be stronger than those treated with bone plate fixation. Clinically, internal fixation and open reduction of clavicular fractures have shown marked success for the union in a relatively expected time frame with low complications.
Intramedullary fixation offers the benefit of smaller scars and lower refracture potential but also bears the potential risk of hardware prominence and a little higher incidence of nonunion. General principles for a successful surgical outcome involve minimizing soft tissue disruption and periosteal stripping as much as possible during exposure, achieving an anatomic reduction, and preventing wound complications and hardware irritation as much as possible with suitable soft tissue hardware coverage. Either dynamic compression plates (DCP) or locked plating constructs can be used, depending on bone quality and fracture type. In general, the orthopedic bone plate is placed on the anteroposterior, or tension side, of the clavicle to result in the most biochemically sound construct.
A fibula fracture refers to a break in the fibula bone. A forceful impact, such as landing after a high jump or any impact to the outer part of the leg, can cause a fracture. Even spraining or rolling an ankle puts stress on the fibula bone, which can lead to a fracture.
Types of Fibula Fracture
Fractures in Fibula can happen at any point on the bone and can differ in type and severity. Types of fibula fracture include:
- Lateral malleolus fractures occur when the fibula is fractured at the ankle
- Fibular head fractures occur at the upper end of the fibula at the knee
- Avulsion fractures happen when a small chunk of bone that is attached to a ligament or tendon is pulled away from the main part of the bone
- Stress fractures describe a condition where the fibula is injured as the result of repetitive stress, such as hiking or running
- Fibular shaft fractures occur in the mid-portion of the fibula after an injury such as a direct blow to the area
- Fibular shaft fractures occur in the mid-portion of the fibula after an injury like a direct blow to the area
- A fibula fracture can be because of several tough injuries. It is commonly associated with a rolled ankle but can also be because of a fall, awkward landing, or a direct blow to the outer ankle or lower leg.
Fibula fractures are most common in sports, especially those that involve jumping, running, or quick changes of direction such as football, basketball, and soccer.
Swelling, pain, and tenderness are some of the most common signs and symptoms of a fractured fibula. Other signs and symptoms include:
- Incapability to bear weight on the injured leg
- Bruising or bleeding in the leg
- Visible deformity
- Coldness and numbness in the foot
- Tender to the touch
People who have injured their leg and are facing any of the symptoms should consult a doctor for diagnosis. The following steps occur during the process of diagnosis:
- Physical examination: A thorough examination will be conducted, and the doctor will look if there are any deformities
- X-ray: These are used to see the fracture and know if a bone has been displaced
- Magnetic resonance imaging (MRI): This type of test provides a more detailed scan and can generate detailed pictures of the soft tissues and interior bones
Computerized tomography (CT), bone scans, and other tests may be ordered to make a more precise diagnosis and judge the severity of the fibula fracture.
Treatment for a fibula fracture can differ and depends greatly on how severe the break is. A fracture is classified as closed or open.
Open fracture (compound fracture)
In an open fracture, either a deep wound exposes the bone through the skin or the bone pokes through the skin and can be seen.
An open fracture is mostly the result of a high-energy trauma or direct blow, such as a motor vehicle collision or fall. This kind of fracture can also occur indirectly such as with a high-energy twisting type of injury.
The force needed to cause these types of fractures means that patients will often receive additional injuries. Some injuries could be potentially life-threatening.
According to the American Academy of Orthopedic Surgeons, there is 40% to 70% rate of associated trauma elsewhere within the body.
Doctors will treat open fibula fractures immediately and look for any other injuries. Antibiotics will be administered to avoid infection. A tetanus shot will also be given if it is essential.
The wound will be cleaned thoroughly, examined, stabilized, and then covered so that it can heal properly. An open reduction and internal fixation with bone screws and bone plates may be essential to stabilize the fracture. If the bones are not uniting, a bone graft may be essential to promote healing. Orthopedic implants such as Bone plates and bone screws can be accessible from orthopedic instruments suppliers.
Closed fracture (simple fracture)
In a closed fracture, the bone is broken, but the skin is left intact
The goal of treating closed fractures is to put the bone back in place, control the pain, give the fracture time to heal, prevent complications, and return to the normal function. Treatment begins with the elevation of the leg. Ice is used to relieve the pain and lessen the swelling.
If no surgery is required, crutches are used for mobility and a cast, brace, or walking boot is recommended while healing takes place. Once the area has healed, persons can stretch and strengthen weakened joints with the help of a physical therapist.
There are two main kinds of surgery if a patient requires them:
- Closed reduction involves realigning the bone back to its original position without the need to make an incision at the site of fracture
- Open reduction and internal fixation realign the fractured bone to its original position using hardware such as bone screws, orthopedic plates, and rods
The ankle will be placed into a cast or fracture boot until the process of healing is complete.
Clavicle (collarbone) fractures make up 44% to 66% of all fractures of shoulder. A doctor can often diagnose a clavicle fracture during a physical evaluation, but X-rays and other tests are often recommended. The fracture may also require surgical intervention when Orthopaedic or trauma Implant may be used to fix the fracture.
Diagnosing Clavicle Fractures
X-rays can help determine the extent and location of the injury. At times it is essential to distinguish between a clavicle fracture and an injury to the joint at the top of the shoulder, called the acromioclavicular joint. A CT scan may also be required for more detailed images.
During the physical examination, the physician may do the following tasks:
- Note areas of tenderness
- Observe skin discoloration
- Look for deformities
- Address any open wounds
- Palpate or touch the shoulder blade and ribs to determine if there is an accompanying injury
- Listen to the lungs with a stethoscope, and observe differences in breathing
- Evaluate the shoulder’s range of motion
A doctor may conduct a neurological examination to make sure that motor functions and sensation are normal. The clavicle is located near a series of nerves found based in the shoulder and neck called the brachial plexus. Injury to the brachial plexus is uncommon but can happen with a clavicle break.
The physician will also ask about the medical history of patient, how the injury occurred, and any symptoms associated with it.
Common Causes and Risk Factors of Clavicle Breaks
They may be caused by:
- An athletic event resulting in a fall or direct hit. Clavicle fractures related to sports are commonly seen in children and young adults. Caution is advised when playing contact sports- including rugby, football, and hockey- and when participating in “extreme” sports where falls can happen- such as skateboarding and biking.
- A fall on the shoulder or an extended arm.
- A direct hit to the shoulder in a collision of motor vehicle.
Falling on the shoulder is the common cause of clavicle fractures.
Risk factors for clavicle breaks include:
- Young age, reaching a high point between the ages of 10 and 19. The clavicle is not entirely developed until about 20 years of age.
- Advanced age in both females and males over the age of 70.
- The onset of osteopenia, which is the early stage of reduced bone maps that can eventually lead to osteoporosis.
While certain people are at greater risk for a clavicle fracture, they can affect any person.
Nonsurgical Treatment for a Clavicle Fracture
Nonsurgical treatment for a broken clavicle can include the following:
- A wrap or arm sling is typically worn after the break occurs. This helps to prevent arm movement as the collarbone recovers.
- Pain medication, typically nonsteroidal anti-inti-inflammatory drugs such as ibuprofen or naproxen, can be taken to reduce pain.
- Physical therapy exercises will be recommended once the collarbone starts to mend. The patient will start with mild movements to ease stiffness. More intense exercises will be added after the recovery of bone.
Surgical Treatment for a Clavicle Fracture
Clavicle surgery may be required if the fractured pieces of bone are not in their anatomical and correct location. (The medical term for this is a displaced fracture). In these cases, the bones need to be secured and moved to heal properly. Bone plates, bone screws, and pins are often used during the surgical process. Rehabilitation after surgery includes exercises that can be done at home or with a physical therapist.
Cervical or spine implants are orthopedic devices orthopedic surgeons use to decompress and stabilize the spine. These devices are implanted either from the front (anterior) of the spine or from the back (posterior). Information about anterior implants starts below.
The Aims Of Cervical Spine Surgery Include:
- Reduce pressure on the nerve(s) by decompression (for instance, surgically removing tissues pushing on a nerve).
- Stabilize the cervical spine by fusing 2 or more cervical vertebrae together.
Anterior Cervical Approach Implants
Interbody Cage or Spacers: Cages and spacers are placed between 2 vertebrae. Their purpose is to:
- Keep space between vertebrae (if space gets so narrow, nerve roots may be pinched).
- Preserve spinal alignment (for instance, a healthy neck has a specific curve; a spacer can facilitate restoring this curve).
- Promote spinal fusion (for instance, join (fuse) 2 or more vertebrae together).
Cages are available in various sizes and shapes; some are cylinder-shaped, and others are box-shaped. Cages are placed or fit into the spine between vertebrae. Usually, cages are made from bone, metal, plastic, or carbon fiber. Bone chips (autograft, allograft, other bone graft alternatives, or other bone growth stimulating materials (for instance, demineralized bone matrix) can be packed into the cage. During the months after surgery, the hope is the cage will allow and improve fusion between the vertebrae above and below. Fusion increases spine stability.
Spacers are solid devices and bone cannot be packed inside. A spacer is utilized to facilitate restoring or correct spine alignment.
Anterior cervical plates are attached to the front of 2 or more vertebrae. Bone plates help to:
- Increase the stability of the cervical spine immediately after surgery.
- Increase the chances for a successful solid fusion.
- Stabilize the cervical spine while healing.
- Help to reduce the time the patient can need wearing a cervical collar after surgery.
Plates are made with screw holes through which bone screws are positioned into the adjacent (to be fused) vertebral bodies to anchor the plates into an accurate place. Both plates and screws are available in various sizes and designs. Most plates are made from metal (mostly titanium); some are produced from plastics. Certain newer plates are manufactured from composite substances that dissolve after fusion happens. Some designs of the plate are self-compressing to help promote spinal fusion.
Artificial Cervical Discs
Spine surgeons of the world have an interest in cervical artificial discs to treat degenerative disease. It’s believed keeping movement between vertebrae is better than spinal fusion. Early studies report cervical artificial discs can help slow down the process or prevent adjacent level disc degeneration. The process is called disc arthroplasty. Artificial discs are produced from various materials. Some designs are all plastics and metal composites and other metal. There are numerous ongoing, and some finished, FDA trials of artificial discs underway in the United States. Devices are being cleared for sale and implantation as the studies show safety and efficacy compared to fusion in selected cases.
If your surgeon suggests cervical surgery, you may be encouraged that cervical decompression and stabilization processes are some of the most successful operations spine surgeons perform presently. Patients often have a rapid recovery and quickly return to activities of everyday living with marked improvement of their symptoms.
Siora Surgicals has launched its new orthopedic product range of spine surgery implants or cervical implants which includes Variable Angle Cervical Locking Plate and Cervical Locking Screws in titanium.