Dynamic Fracture Fixation Plates: A Systematic Review of Evolving Design Approaches

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Materials science

Background:

• Standard locked plates for fracture fixation can impede interfragmentary motion, crucial for secondary bone healing.
• Dynamic fracture fixation plates aim to preserve structural rigidity while enabling controlled axial micromotion.

Purpose of the Study:

• To conduct a systematic review of dynamic plating technologies for fracture fixation.
• To inform future development of dynamic plating by analyzing current innovations.

Main Methods:

• A systematic literature and patent review was conducted using PRISMA guidelines.
• 59 records (51 articles, 8 patents) detailing 26 unique dynamic plating devices were analyzed.
• Devices were categorized by engineering approach and compared by technological characteristics.

Main Results:

• Dynamic plating concepts include sliding mechanisms, elastic inserts, lattice structures, and compliant flexures.
• Many dynamic technologies show positive experimental and clinical healing outcomes.
• Widespread clinical adoption is limited by factors such as production costs and existing fixation options.

Conclusions:

• Dynamic plating represents a promising innovation for improving bone healing and addressing non-union rates.
• Further development is needed to overcome barriers to clinical implementation.
• Optimizing dynamic plating could enhance outcomes for long bone fractures.