Review Application of composites to orthopedic prostheses for effective bone healing: A review Hassan Mehboob, Seung-Hwan Chang ⇑ School of Mechanical Engineering, Chung-Ang University, 221, Huksuk-Dong, Dongjak-Gu, Seoul 156-756, Republic of Korea article info Article history: Available online 7 August 2014 Keywords: Composite materials Prostheses Mechano-regulation theory Bone healing Fracture fixation abstract This paper aims to provide useful and practical information on the design of composite prostheses for healing bone fractures and describes the material properties of living tissues such as cartilage, structural materials and loading conditions according to various cases, and modeling techniques for the simulation of tissue differentiation during bone healing. In addition, the present review paper provides an overview of composite materials for the design of prostheses and highlights the merits of using composites. The history and recent trends in fixation methods and types, types of materials used for prostheses, loading conditions, mechano-regulation theories, and modeling techniques for finite element analyses to estimate the healing of bone fractures are also introduced. The healing process of bone fractures is fully influenced by the biomechanical characteristics of an orthopedic prosthesis and the injured bone such as fracture configurations, prosthesis shape, material properties, and degradation rate of the material. The appropriate parameters are highlighted for the optimal design of composite prostheses to heal bone fractures successfully. Ó 2014 Elsevier Ltd. All rights reserved. Contents 1. Introduction ......................................................................................................... 329 1.1. Fixation techniques .............................................................................................. 329 1.2. Defects of conventional prostheses ................................................................................. 329 1.3. Mechano-regulation theories ...................................................................................... 329 1.4. Conditions of implants for successful healing ......................................................................... 329 1.5. Materials and designs for composite prostheses ....................................................................... 329 2. History, development, and methods of fracture fixation ...................................................................... 330 2.1. History and development of fixation devices ......................................................................... 330 2.2. Types of fixation techniques and devices ............................................................................ 332 3. MR theories correlating mechanical conditions and tissue development ......................................................... 332 3.1. History of MR theory............................................................................................. 332 3.2. Applications of MR theories ....................................................................................... 333 4. Biomechanical conditions for simulated bone fracture models................................................................. 333 4.1. Biomechanics ................................................................................................... 333 4.2. Computer models for the bone healing process ....................................................................... 333 5. Biomaterials used for prosthesis design and fabrication ...................................................................... 333 5.1. Metals ........................................................................................................ 333 5.1.1. Nondegradable metals .................................................................................... 333 5.1.2. Biodegradable metals ..................................................................................... 336 5.2. Bioceramics .................................................................................................... 336 5.3. Polymers ...................................................................................................... 336 5.4. Polymer-based composite materials ................................................................................ 336 http://dx.doi.org/10.1016/j.compstruct.2014.07.052 0263-8223/Ó 2014 Elsevier Ltd. All rights reserved. ⇑ Corresponding author. Tel.: +82 2 820 5354; fax: +82 2 814 9476. E-mail address: phigs4@cau.ac.kr (S.-H. Chang). Composite Structures 118 (2014) 328–341 Contents lists available at ScienceDirect Composite Structures journal homepage: www.elsevier.com/locate/compstruct