The burden of bone fractures demands development of effective biomaterial solutions, while additional acute events such as noncompressible bleeding further motivate the search for multi-functional implants to avoid complications including osseous hemorrhage, infection, and nonunion. Bone wax has been widely used in orthopedic bleeding control due to its simplicity of use and conformation to irregular defects; however, its nondegradability results in impaired bone healing, risk of infection, and significant inflammatory responses. Herein, a class of intrinsically fluorescent, osteopromotive citrate-based polymer/hydroxyapatite (HA) composites (BPLP-Ser/HA) as a highly malleable press-fit putty is designed. BPLP-Ser/HA putty displays mechanics replicating early nonmineralized bone (initial moduli from ≈2–500 kPa), hydration induced mechanical strengthening in physiological conditions, tunable degradation rates (over 2 months), low swelling ratios (<10%), clotting and hemostatic sealing potential (resistant to blood pressure for >24 h) and significant adhesion to bone (≈350–550 kPa). Simultaneously, citrate's bioactive properties result in antimicrobial (≈100% and 55% inhibition of S. aureus and E. coli) and osteopromotive effects. Finally, BPLP-Ser/HA putty demonstrates in vivo regeneration in a critical-sized rat calvaria model equivalent to gold standard autograft. BPLP-Ser/HA putty represents a simple, off-the-shelf solution to the combined challenges of acute wound management and subsequent bone regeneration.

中文翻译：

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可生物降解的柠檬酸盐骨促进剂的开发

骨折的负担需要开发有效的生物材料解决方案，而不可压缩性出血等其他急性事件进一步促使人们寻找多功能植入物，以避免骨出血、感染和骨不连等并发症。骨蜡因其使用简单且能针对不规则缺损而广泛应用于骨科止血；然而，其不可降解性会导致骨愈合受损、感染风险和显着的炎症反应。本文设计了一类本质荧光、促骨柠檬酸盐聚合物/羟基磷灰石 (HA) 复合材料 (BPLP-Ser/HA) 作为高延展性压接腻子。BPLP-Ser/HA 腻子显示出复制早期非矿化骨的力学特性（初始模量约为 2–500 kPa）、生理条件下水合诱导的机械强化、可调节的降解率（超过 2 个月）、低膨胀率（<10%）、凝血止血密封潜力（耐血压>24小时）和显着的骨粘附力（约350-550 kPa）。同时，柠檬酸盐的生物活性特性可产生抗菌作用（对金黄色葡萄球菌和大肠杆菌的抑制率约为 100% 和 55% ）和骨质促进作用。最后，BPLP-Ser/HA 腻子在临界大小的大鼠颅盖模型中证明了体内再生，相当于金标准自体移植物。BPLP-Ser/HA 腻子代表了一种简单、现成的解决方案，可应对急性伤口处理和随后的骨再生的综合挑战。