Biomechanics of Plate and Screw Constructs for Fracture Fixation

Plates and screws have been used for the internal fixation of fractures for more than a century. In the beginning, implants were produced without consistency and with no standardization. As a result, many failures were reported, either related to metal corrosion or the weakness of the bone-implant construct. In the 1950s, a revolution took place in the internal fixation of the fractures, mostly driven by a set of principles formulated by the Association for the Study of Internal Fixation in Switzerland. Plates are very versatile tools which may be assembled to perform a variety of biomechanical functions. Consequently, the use of plates and screws in the fixation of fractures may be associated with primary or secondary bone healing. The complete understanding of the biomechanics of plates in the internal fixation of fractures is of paramount importance for reproducible and successful outcomes.