Advances in Bone Adhesives: A Developmental Overview

Fracture represents a prevalent public health concern. The escalating incidence of traumatic fractures, particularly accompanying accelerated demographic aging in numerous countries, has intensified the demand for effective treatment solutions. Clinically, mechanical fixation remains the most efficacious approach for fracture management, necessitating extensive utilization of rigid orthopedic devices including bone nails, plates, and splints. However, metallic internal fixation systems exhibit inherent limitations in biodegradability and lack of osteogenic promotion during bone healing. Moreover, these conventional methods prove insufficient for treating severe bone trauma such as comminuted fractures. To address these limitations, bone adhesives have been developed as innovative materials for comprehensive bone repair. Demonstrating liquid-phase adhesion capability at injury sites followed by solidification-induced stabilization, these systems offer significant advantages in operational convenience and therapeutic efficacy. This review systematically categorizes bone adhesives into three chemically and methodologically distinct classes: synthetic polymeric adhesives, natural biomatrix-based adhesives, and bio-inspired hybrid adhesives. Through structural analysis of chemical compositions and preparation protocols, we examine the correlation between functional groups and molecular architectures with clinical performance characteristics. Evaluations focus on identifying advantages and disadvantages in osteogenic potential, biocompatibility, and mechanical stability across material categories. By elucidating the structural rationale underlying successful clinical applications, this work aims to establish a foundational framework for guiding future adhesive development. The systematic analysis of material properties and functional mechanisms presented herein seeks to clarify developmental pathways and stimulate broader interdisciplinary research engagement in this field.