A critical review on bone plates: state of the art and future directions

The article provides an in-depth overview of the mechanical, chemical, and biological properties of engineering materials used for orthopedic bone plates, along with their designs and fabrication methods. This review addresses the benefits and drawbacks of various materials that have been utilized as bone plates for the treatment of fractures and bone abnormalities. Due to their excellent mechanical properties, metallic bone plates have traditionally been employed for bone fracture fixation. However, the mismatch in mechanical properties and high density of metallic bone plates can lead to stress shielding and non-union, often requiring revision surgeries. These challenges are highlighted in the review, which then explores the potential of polymeric plates to overcome such issues. Nevertheless, the insufficient mechanical performance of polymeric bone plates often necessitates the development of composite bone plates that are patient-specific, biocompatible, and easily tailorable. Emerging research initiatives in this area are discussed. The article further elaborates on various fabrication processes and their impact on the surface properties of bone plates. Both conventional machining processes for internal fixation devices and 3D printing methods for fabricating patient-specific, customized bone plates are reviewed. The paper concludes by evaluating current advancements and anticipated developments related to bone plate technology.