[Stress protection in plate osteosynthesis: myth or reality?]

It is generally admitted that plate fixation of fractures results in reduced stress (stress protection) and subsequent structural adaptation of bone (bone loss). The analysis of the stress pattern and the reduction of deformation work in plated bones is a prerequisite for the assertion that bone loss is stress related. The strain field within bones under eccentric axial load has been analyzed theoretically and verified experimentally. The difference between the reduction of stress obtained using the flexible plate materials is small. Reduction of plate stiffness does not result in proportional improvement of the bone strain.