The Role of Locking Plate Stiffness in Bone Fracture Healing Stabilized by Far Cortical Locking Technique

Abstract

The locking plate fixations have been developed to enhance bone healing by wide bridging of the fracture and allowing some level of interfragmentary movement (IFM) at the fracture site. However, the IFM induced by conventional locking plate constructs is not uniform at the fracture site and so result in asymmetric callus formation, and ultimately delayed healing. The far cortical locking technique has been recently innovated to address this issue by inducing a uniform IFM. However, the far cortical locking technique is still in its infancy and more research efforts are required before its practical clinical application. Using the theory of porous media and computational methods, this study investigated the effectiveness of far cortical locking technique in presence of different mechanical stiffness of locking plate. The research outcomes indicate that the application of far cortical looking technique enhances IFM at near cortex, and so reduce the difference of IFM between near and far cortex. Further, it shows that, under far cortical locking technique, the bending stiffness of a locking plate plays an important role in bone healing. The use of a stiffer locking plate together with far cortical locking screws encourages more uniform tissue development across the fracture gap. The current research underlines the importance of the optimal selection of plate stiffness for application of far cortical locking technique.