The influence of screw torque, object radius of curvature, mode of bone plate application and bone plate design on bone-plate interface mechanics.

Using Fuji Prescale Pressure Sensitive Film we evaluated the influence of screw torque, object radius of curvature, mode of bone plate application (compression or neutral loading) and bone plate design on bone-plate interface mechanics. Testing was performed using 4.5 mm and 3.5 mm dynamic compression (DC) (stainless steel) and limited contact-dynamic compression (LC-DC) plates (titanium). Plexiglass tubing, having different radii of curvature, was used to simulate bone but having more uniform geometric and structural properties. With the film interposed between the bone plate and the plexiglass, bone plates were applied at predetermined levels of screw torque. The resultant image was digitized and then underwent computer-assisted analysis to yield the interface contact area (%) and the average force (in Newtons N) between the bone plate and the object to which it was applied. In any given object, screw torque had the most significant influence on both interface contact area (P = 0.0001) and average force (P = 0.0001) at the interface. The bone plates responded differently to dynamization. The DC plate, when applied in compression loading mode, was lifted off the object between the two central screws when compared to the same plate applied in neutral loading mode (P = 0.0001). Conversely, in the LC-DC plate, an increase in the overall interface contact area was observed when applied in compression loading mode (P = 0.0002). At a given level of applied screw torque, the object radius of curvature appeared to be a major determining factor for interface contact area and average force (P = 0.0001, P = 0.0001). We conclude that variables other than bone plate design also influence the interface contact area and average force between a bone plate and object to which it is applied.