Effects on intact femora of dogs of the application and removal of metal plates. A metabolic and structural study comparing stiffer and more flexible plates.

Studies of flexible plates made of plastic have shown that less osteoporosis develops beneath them than beneath rigid metal plates. However, to date plastic plates of appropriate physical properties and biocompatibility are not available for use in humans. To determine if a similar beneficial effect could be obtained using metal plates, the effects of thick chromium cobalt plates were contrasted in experiments in dogs with the effects of thinner plates of similar design made of titanium, 6-aluminum, 4-vandium. A significant reduction in the osteoporosis was obtained by use of the more flexible plates. Following plate application a delayed, massive, transient stimulus to bone formation occurred endosteally, periosteally, and intracortically. Despite this, a substantial decrease in bone mass occurred, primarily mediated by endosteal bone resorption. Intracortical porosity played little or no role in net bone loss. The major effects subsided by six months. Recovery after plate removal was predominantly the result of endosteal new-bone formation.