An orthopedic plate is a form of

internal fixation Internal fixation is an Surgery, operation in orthopedics that involves the surgical implementation of Implant (medicine), implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable fo ...

used in

orthopaedic surgery Orthopedic surgery or orthopedics (American and British English spelling differences, alternative spelling orthopaedics) is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgic ...

to hold

fractures Fracture is the appearance of a crack or complete separation of an object or material into two or more pieces under the action of stress (mechanics), stress. The fracture of a solid usually occurs due to the development of certain displacemen ...

in place to allow

bone healing Bone healing, or fracture healing, is a proliferative physiological process in which the body facilitates the repair of a bone fracture. Generally, bone fracture treatment consists of a doctor reducing (pushing) displaced bones back into place ...

and to reduce the possibility of

nonunion Nonunion is permanent failure of healing following a broken bone unless intervention (such as surgery) is performed. A fracture with nonunion generally forms a structural resemblance to a fibrous joint, and is therefore often called a "false jo ...

. Most modern plates include bone screws to help the orthopedic plate stay in place.

Historic overview

Prior to the invention of the orthopedic plate, metal wiring was used to solve the issue of bone fractures until about 1850. It was debated when the first use of this technique was actually made. Supposedly, the first use of this metal wiring was by the ancient Greeks. The first recorded use of metal wiring was in 1755 in a French journal. It was not until 1870, a Frenchman by the name of Laurent Berenger-Feraud began writing a book on internal fixation and bone fractures called "''"'' (a book on direct immobilization of bone fragments of fractures). All the information proved to be beneficial in medical procedures, however one thing lacked, the antiseptic treatments needed to properly administer these techniques. Joseph Lister, a British assistant surgeon who in 1877 tried his techniques on a patient and showed huge success. Carl Hausmann is credited with making the first successful plate using both nickel sheets and screws and creating a method of removal without reopening the wound site in 1886. The years following focused on better surgical techniques and experimentation with other materials. Metals were the most common material for orthopedic plates, until cytotoxic tests were used to determine biocompatibility of metals put into the patients body post operation. Modern orthopedic plating did not start until the 1950s where Maurice Muller formed AO/ASIF (Association for the study of internal fixation) along with other surgeons to better improve plating techniques. The purpose of the AO were to better understand bone repair, fracture formation and surgical techniques to gain better results in medical applications.

Materials

Previously used materials

Source: * Gold * Ivory horn * Nickel * Magnesium * Copper alloys * Zinc alloys * Silver * Lead

Current materials

Source: * Titanium * Medical grade steel * Cobalt-based alloys * Bioceramics * Metal composites * Polymers

Classifications of orthopedic plates by usage

Orthopedic plates are designed based on the bone fracture. While the general design is similar, each plate must be manufactured to not only to reduce the fracture but also fit the contour of the patient's bone. Protection Locking plates can be used either to support a locking head screw, or to force bone together at the fracture. Locking head screws can be applied at the fracture, with the orthopedic plate in place to reduce applied force on the bone fracture. Tension and Compression Compression plates can be implanted in such a way that it is in tension, forcing the bone together at the fracture. The use of an articulated tension device can also be used to compress the bone together by pulling the compression plate. Bridging For fragmentary bone fractures, bridging plates can be used to hold the bone in place when there are no anchor points at the fracture point. Bridging can allow for relative stability along the bone, while not disturbing the bone fragments. Buttress Buttress plates, or concave plates, are useful for fractures along concave surfaces. Due to the angle of the bone, the contour of the concave plate aligns with the bone, providing even compressive force along the fracture.

Historic overview

Materials

Previously used materials

Current materials

Classifications of orthopedic plates by usage

Applications

Different plate types

Modes of use

See also

References