The Journal of Bone and Joint Surgery, Vol 66, Issue 7 1084-1091, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Comparison of the effects of compression plates and external fixators on early bone-healing
DG Lewallen, EY Chao, RA Kasman and PJ Kelly
We used two mechanically dissimilar devices, compression bone-plates and
unilateral-frame external fixators, in a standard canine osteotomy model;
both methods were highly successful in achieving mature bone union. Bone
union was studied by histological, physiological, and biomechanical means.
At 120 days after injury, union was biomechanically less mature on the
external fixator side. These tibiae had less intracortical new-bone
formation (p less than 0.01), more bone resorption (p less than 0.045), and
more bone porosity (p less than 0.04) when compared with paired tibiae that
had been treated with compression plates. This higher level of bone
turnover on the external fixator side was accompanied by an increase in
blood flow (measured by clearance of 85Sr) (p less than 0.04). At the
osteotomy site, pre-experimental or unlabeled bone and porosity were
greater on the external fixator side and endosteal new-bone formation was
greater on the plated side. Since the in vitro stiffness of the external
fixator was less in all modes tested (compression, distraction, torsion,
and anteroposterior bending) except lateral bending, it may be that the
rigidity of the fixation is an important factor in early bone-remodeling of
a healing osteotomy.
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