The relationship between porosity, collagen fiber orientation and strength of plated bone after rigid plate fixation and removal / 中华创伤杂志(英文版)

ABSTRACT

OBJECTIVE: To understand the relationship between porosity, collagen fiber orientation and strength of the plated bone after rigid plate fixation and removal. METHODS: Seventy-two New Zealand white rabbits were used in this experiment. Eight animals served as control and the other sixty-four were plated on their intact left tibiae with stainless steel (316L) 4-hole plates to induce early osteoporosis. The plates were removed 2 months after internal fixation in 40 plated animals, 8 of which were sacrificed immediately following plate removal and the other 32 were killed in successive groups with 8 in each group 1, 2, 3 and 4 months after plate removal. The remaining 24 plated animals were killed at 3, 4 and 6 months after plate fixation. After sacrifice, the samples of plated bone were prepared for light microscope, quantitative histological analysis, polarized light microscope and biomechanical test. RESULTS: The internal fixation with a rigid plate could induce the regional osteoporosis which manifested both bone loss and disorganized bone structure (loss of the orientation of the collagen fibers) leading to decreased strength of the plated bone. Although the regional osteoporosis could recover gradually after plate removal, the bone structure remained disorderly even when the bone mass returned to normal. Delayed restoration of bone structure was related to delayed restoration of bone strength. CONCLUSIONS: Besides the bone loss, the disorganized bone structure is the main cause of decrease of bone strength after rigid plate fixation and removal.