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Life
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Reconstruction of Bone Defects
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Reconstruction of Bone Defects

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 1 November 2025 | Viewed by 2741

Special Issue Editors

Dr. Jörg Eschweiler

E-Mail Website
Guest Editor
1. Department of Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost, Merseburgerstr. 165, 06112 Halle, Germany
2. Department of Trauma and Reconstructive Surgery, University Hospital Halle, Ernst-Grube-Str. 40, 06120 Halle, Germany
Interests: biomechanics; orthopedic surgery; bioengineering
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Philipp Kobbe

E-Mail Website
Guest Editor
1. Department of Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost, Merseburgerstr. 165, 06112 Halle, Germany
2. Department of Trauma and Reconstructive Surgery, University Hospital Halle, Ernst-Grube-Str. 40, 06120 Halle, Germany
Interests: pelvic and spine surgery; traumatology; seriously injured care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Bone defects still represent a major challenge for orthopedic and trauma surgeons. They are serious complications that are most commonly caused by trauma, tumor, infection, and failed arthroplasty or congenital musculoskeletal disorders. Bone defects entail a sustained increase in hospitalization, risk of complications, and associated increase in expenses. Skeletal reconstruction of bone defects is challenging and can be lengthy with often unpredictable outcomes.

Surgical management aims to reconstruct the bone defect, avoiding amputation and providing acceptable functional outcomes. The most common and widely accepted procedures are, e.g., the vascularized bone-free transfer and Ilizarov bone transport techniques.

The healing of bone defects is a well-orchestrated physiological process involving multiple cell types and signaling molecules interacting at the fracture site to replace and repair bone tissue without scar formation. In the case of a bone nonunion, the implantation of, e.g., biomaterials as defect-filler-like scaffolds for repairing these defects and bone regeneration, respectively, is essential.

This Special Issue aims to detail the latest progress and research in treating bone defects, touching on biomechanics, implants, biomaterials, and clinical outcomes. 

We welcome submissions of original research and comprehensive review perspectives, including, but not limited, to the following fields:

  • Bone and fracture biomechanics;
  • Bone healing;
  • Critical size bone defects;
  • Fracture non-union;
  • Inflammation;
  • Joint arthroplasty and fracture osteosynthesis;
  • Implant designs;
  • Materials proprieties;
  • Patient selection;
  • Primary and revision settings.

Dr. Jörg Eschweiler
Prof. Dr. Philipp Kobbe
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bone and fracture biomechanics
  • bone healing
  • critical size bone defects
  • fracture non-union
  • inflammation
  • joint arthroplasty and fracture osteosynthesis
  • implant designs
  • materials proprieties
  • patient selection
  • primary and revision settings

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

15 pages, 3064 KiB  
Article
Assessment of Primary Stability and Micromotion of Different Fixation Techniques for Scapular Spine Bone Blocks for the Reconstruction of Critical Bone Loss of the Anterior Glenoid—A Biomechanical Study
by Anton Brehmer, Yasmin Youssef, Martin Heilemann, Toni Wendler, Jean-Pierre Fischer, Stefan Schleifenbaum, Pierre Hepp and Jan Theopold
Life 2025, 15(4), 658; https://doi.org/10.3390/life15040658 - 16 Apr 2025
Viewed by 343
Abstract
Anteroinferior shoulder dislocations require surgical intervention when related to critical glenoid bone loss. Scapular spine bone blocks have emerged as a promising alternative to traditional bone augmentation techniques. However, limited data exist on their biomechanical stability when using different suture-based fixation techniques. This [...] Read more.
Anteroinferior shoulder dislocations require surgical intervention when related to critical glenoid bone loss. Scapular spine bone blocks have emerged as a promising alternative to traditional bone augmentation techniques. However, limited data exist on their biomechanical stability when using different suture-based fixation techniques. This study aimed to evaluate primary stability and micromotion after glenoid augmentation using a scapular spine bone block. A total of 31 fresh-frozen human shoulder specimens underwent bone block augmentation. The specimens were randomized into three groups: double-screw fixation (DSF), single-suture bone block cerclage (SSBBC), and double-suture bone block cerclage (DSBBC). Biomechanical testing was conducted using cyclic loading (5000 cycles at 1 Hz) and micromotion was analyzed using an optical 3D measurement system. Statistical analysis showed that medial irreversible displacement was significantly greater in the SSBBC group compared to DSF (p = 0.0386), and no significant differences were found in anterior or inferior irreversible displacements. A significant difference was noted in posterior reversible displacement (p = 0.0035), while no differences were found in inferior or medial reversible displacements. Between DSF and DSBBC, no significant differences were found in irreversible or reversible displacements in any direction. DSBBC provided stability comparable to DSF while offering a viable metal-free alternative. In contrast, SSBBC displayed inferior biomechanical properties, raising concerns about its clinical reliability. Full article
(This article belongs to the Special Issue Reconstruction of Bone Defects)
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12 pages, 521 KiB  
Article
Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study
by Fábio Lucas Rodrigues, Ana Lya Moya Ferrari, Fernando Ferraz Faria, Rafael Luiz Emmanoel Pinto, Manuela Fernandes Lopes, Maria Eduarda Alencar Santos, Evelyn Cardenas Varela, Manuel Jucelino Lopes Filho, Marianna Nogueira Cecyn and Nelson Henrique Carvalho de Oliveira
Life 2025, 15(4), 540; https://doi.org/10.3390/life15040540 - 26 Mar 2025
Viewed by 301
Abstract
Intramedullary nails (IMNs) are the most frequent surgical fixation method for femur fractures. Although IMNs provide good healing outcomes and low complication rates, concerns persist regarding potential complications such as malunion, nonunion, and infections. This multicenter retrospective study aims to assess the epidemiology [...] Read more.
Intramedullary nails (IMNs) are the most frequent surgical fixation method for femur fractures. Although IMNs provide good healing outcomes and low complication rates, concerns persist regarding potential complications such as malunion, nonunion, and infections. This multicenter retrospective study aims to assess the epidemiology and outcomes of IMNs for diaphyseal femoral fractures. Data from 91 patients who underwent IMN fixation at two Brazilian hospitals between 2020 and 2024 were analyzed, with a mean age of 33.3 years (SD ± 12.7) and 76.9%% of male patients. Traffic accidents were the most common mechanism of trauma (84.61%). The bone healing rate was 96.7% within six months, and 98.9% within one year, with a complication rate of 3.26%, including two cases of pseudoarthrosis, one case of pseudoarthrosis and infection, and two reoperations. There was a significant association between previous external fixation and fracture type (open/closed) (χ2(1) = 17.5, pFischer < 0.001). Previous external fixation was also associated with lower consolidation rates six months post-surgery (χ2(1) = 9.83, pFischer = 0.031), but not after one year (χ2(1) = 8.19, pFischer = 0.11). The retrograde approach was associated with a lower consolidation rate after six months (χ2(1) = 6.98, pFischer = 0.027), but no significant association was found after one year (χ2(1) = 2.27, pFischer = 0.308). Only one patient with pseudoarthrosis did not consolidate after one year. The outcomes support the efficacy of IMNs in achieving bone consolidation with low complication rates. Full article
(This article belongs to the Special Issue Reconstruction of Bone Defects)
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10 pages, 6393 KiB  
Article
Introducing the Pearl-String Technique: A New Concept in the Treatment of Large Bone Defects
by Christian Fischer, Steffen Langwald, Friederike Klauke, Philipp Kobbe, Thomas Mendel and Marc Hückstädt
Life 2025, 15(3), 414; https://doi.org/10.3390/life15030414 - 7 Mar 2025
Viewed by 532
Abstract
The reconstruction of long bone defects after the primary traumatic, secondary infectious, or tumor-related loss of substance continues to represent a surgical challenge. Distraction osteogenesis using segmental transport, vascularized bone transfer, and the induced membrane technique (IMT) are established methods of reconstruction. IMT [...] Read more.
The reconstruction of long bone defects after the primary traumatic, secondary infectious, or tumor-related loss of substance continues to represent a surgical challenge. Distraction osteogenesis using segmental transport, vascularized bone transfer, and the induced membrane technique (IMT) are established methods of reconstruction. IMT has become increasingly popular in recent decades due to its practicability, reproducibility, and reliability. At the same time, the original technique has undergone numerous modifications. The results are correspondingly heterogeneous. This article is intended to provide an overview of the current principles and modifications of IMT, outline the causes of failure of the IMT, and introduce the pearl-string technique (PST). The PST developed in our hospital is based on the pearl-string-like arrangement of thermodisinfected, decorticated femoral heads (TDFHs) in combination with a mechanically stable osteosynthetic construct. The TDFHs are biologically activated with either an RIA or autologous iliac crest bone graft. To gain a better understanding of these variations, the surgical technique of both procedures is illustrated step-by-step in this article. Full article
(This article belongs to the Special Issue Reconstruction of Bone Defects)
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9 pages, 1207 KiB  
Article
Trends in Cartilage Repair Techniques for Chondral Defects in the Hip in Germany: An Epidemiological Analysis from 2006 to 2022
by Sebastian Frischholz, Tizian Heinz, Manuel Weißenberger, Sebastian Philipp von Hertzberg-Boelch, Philip Anderson, Martin Lüdemann, Axel Jakuscheit, Maximilian Rudert and Ioannis Stratos
Life 2024, 14(10), 1262; https://doi.org/10.3390/life14101262 - 3 Oct 2024
Viewed by 984
Abstract
Cartilage repair techniques for chondral defects in the hip are crucial for treating conditions like femoroacetabular impingement, developmental dysplasia, and osteonecrosis, especially in young patients to delay the progression of osteoarthritis. This study aims to present age and sex distributions and trends in [...] Read more.
Cartilage repair techniques for chondral defects in the hip are crucial for treating conditions like femoroacetabular impingement, developmental dysplasia, and osteonecrosis, especially in young patients to delay the progression of osteoarthritis. This study aims to present age and sex distributions and trends in hip-preserving surgeries in Germany from 2006 to 2022, analyzing 116,179 procedures using the German OPS coding system. The procedures were categorized into three groups: debridement, refixation, and regeneration. Arthroscopy was more common than arthrotomy (98,916 vs. 17,263). Males underwent more procedures than females (63,771 vs. 52,408). Debridement had a monomodal age distribution peaking at 43.42 years, while refixation and regeneration exhibited bimodal patterns. Regenerative procedures were primarily performed on younger patients (average 27.73 years). A Joinpoint analysis showed an initial increase in procedures, peaking around 2013, followed by a decline. Arthroscopic procedures peaked at approximately 9000 in 2013, whereas arthrotomies peaked at around 1200 after 2014. The decline in procedures post-2013 may reflect refined surgical indications and a shift towards outpatient settings. These findings underscore the trend towards minimally invasive, scaffold-based treatments, with regenerative techniques showing promising outcomes in younger patients. Future research should focus on prospective comparative studies and cost–benefit analyses to guide clinical decision-making. Full article
(This article belongs to the Special Issue Reconstruction of Bone Defects)
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