الفهرس 
Biology of Bone HealingOnly 14 pages are availabe for public view
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Abstract
Fracture treatment by internal fixation has undergone important changes in recent years. The original emphasis on the mechanical aspects has shifted towards biological considerations with preservation of the viability and the integrity of the soft tissue envelope. Increased evidence for the importance of the biological factors in fracture healing led to the development of the concept of biological internal fixation of fractures.
Conventional stable internal fixation with precise reduction usually requires a fairly extensive surgical approach to the bone. This contributes to increasing the necrosis , which has been initially produced by the injury , consequently increasing the risk of delayed healing , infection and possibly refracture. A demanding degree of skill and expertise is required at operation to minimize the biological complications following extended traumatic and iatrogenic necrosis.
In this study, the Biological way of fixation is used by different types of plates for treatment of 20 cases with complex femoral fractures. 14 of the patients were males and 6 were females with range of age from 23 to 70 years The most common cause was road traffic accident in 15 Patients (75%). 5 patients (25%) developed these fractures as a result of direct trauma.
Final results reported after 12 months after operation. The time of surgery was from 1 to 10 days after injury. All fractures were complex type II (20%) , type III (40%) and type III (40%) winquist classification.
They were all evaluated both clinically and radiologically. The clinical results were assessed according to Neer et al. scoring system. Radiological evaluation included assessment of union, malunion, failure of fixation, angulation and implant failure. The Neer system used in this work depends on six factors which are pain, joint movement, walking capacity, anatomy, roentgenogram and work capacity. Each factor is rated from 0 to 20 and the total score represents the summation of points of the six factors (100 points).
It was found that 19 (95 %) had satisfactory results and 1 (5%) had unsatisfactory results .
from the overall results of this work and in comparing with other works which used traditional plate fixation, it was found that plating with biological principles is superior than traditional plate fixation as it is easier method despite that they are considered as major operation. The patients are usually young with good general condition.
Biological plating of femoral fractures not only fulfills the demands of treating these fractures using minimally invasive technique and provides an excellent biomechanical and biological environment for fracture healing, but is considered one of the best choices of treatment.
In conclusion, biological internal fixation demonstrates a fascinating link between biology and biomechanics after surgical fracture stabilization. Using of minimal invasion techniques in fractures gives better results so, biological plate fixation is highly recommended as it has promising results and has many advantages over the other fixation techniques .