History and philosophy of attachment of prostheses to the musculo-skeletal system and of passage through the skin with inert materials

✍ Scribed by Murphy, Eugene F.

• Publisher: John Wiley and Sons
• Year: 1973
• Tongue: English
• Weight: 990 KB
• Volume: 7
• Category: Article
• ISSN: 0021-9304
• DOI: 10.1002/jbm.820070319

✦ Synopsis

Abstract

The history of passage through the skin and of attachment to bone to treat fractures is briefly sketched since the work of Malgaigne in 1843. Attachment of metal to bone for many months is now routine after open reduction of fractures and is quite successful for many years for completely buried hip prostheses. Passage through the skin, the gums, or the cornea has been used in many specialties. At least half a dozen investigators have attempted skeletal attachment of artificial limbs.

Even if absolute solutions are impossible, perhaps temporary successes might be extended by one or two orders of magnitude (adequate for a lifetime) by increased attention to engineering details. The role of ASTM Committee F–4, Surgical Implants, is noted. An important principle may be matching of stiffness, or at least tapering of the transition in stiffness, between implant and tissue. This precaution should reduce local stress concentrations tending to loosen attachment to bone or to reopen mechanical adherence of tissue to implant, opening a pathway for infection.