The extent of stress-protection after plate osteosynthesis in the human tibia

The extent of stress-protection was investigated in 12 patients with previous tibial fractures treated by steel plate fixation. They were examined by computed tomography (CT) scanning one or two days after plate removal. The cortical density and thickness were determined by the CT scans. In the previously plated segment, a significant reduction in cortical density was found, and the reduction was most pronounced in the quadrant directly beneath the plate. The osteopenia did not increase with increasing duration of plate application in excess of one year. No significant differences in cortical thickness between plated and control tibiae occurred. The results indicate that stress-shielding after rigid plating in the human tibia is less pronounced than that previously reported from experimental studies in animals.