Pattern of screw loosening in fractures fixed with conventional and functional plates

Plate fixation depends mainly on the holding power of the screws. In the present study the pattern of screw loosening was investigated. Thirty-two adult female sheep divided into four groups were used. A mid-diaphyseal transverse osteotomy was made on the right radius of each animal, and then plated on the anterior (tension) surface. Half of each group were plated using a standard narrow 7-hole AO Dynamic Compression Plate (DCP), whereas in the remaining animals a 6-hole newly designed sliding plate (SP) was applied. The required torque of tightening intraoperatively, as well as for releasing the screws after killing the animals was recorded with a tension-calibrated screwdriver. The pattern of loosening was similar for all the screws and the three phases could be recognized. An initial loosening was observed 1 month after the operation. A slow recovery of the torque was measured from the second month onwards, becoming highest by the fourth month after the operation, whereas a slow decrease in torque was observed from the fourth to the sixth month. In the SP group, the overall loosening was much lower than the DCP group (P < 0.05), whereas there was no difference in the loosening between the proximally placed screws and the distally placed ones (P > 0.05) for both plates.