The Effect of the Dynamic Compression Plate on Cortical Vascularity after Fracture Healing: a Study in the Beagle Dog

Abstract

Aim: The use of dynamic compression plates (DCP) has been associated with cortical bone porosis which has been postulated by some to occur secondary to the disruption of cortical blood flow beneath the plate. This hypothesis has prompted the development of novel plate designs that minimize the area of contact between plate and bone. However, the evidence that supports an ischemic etiology for the cortical porosis beneath the DCP comes primarily from studies in intact plated bones. There are few studies that utilize a fracture model to examine the effects of plating with the DCP on cortical bone perfusion. The goal of this study was to evaluate cortical bone vascularity beneath the DCP via injection studies after healing in a beagle fracture model.
Methods: An unilateral osteotomy was created in the radii of ten skeletally mature female dogs and a DCP was implanted. Twelve weeks after surgery, the dogs were euthanized and the cortical vascularity was visualized and digitally analyzed.
Results: Our results showed no significant difference in the cortical vascularity beneath the plate when compared to the cortex opposite the plate. However, the cortex of the non-plated/non-fractured control had significantly less vascularity than the cortices from the fractured, plated bones (p < 0.05).
Conclusion: The DCP has been used successfully in fracture management for the past thirty years. This study does not support the premise that the DCP prevents normal revascularization following fracture fixation and healing. The purported disadvantage of the high contact DCP may be negligible following healing and remodeling of fractured long bones.

Key words

DCP - Internal fixation - Porosis - India ink - Radius

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