The evolution of modern plate osteosynthesis.

Plate osteosynthesis is still recognized as the treatment of choice for most articular fractures, many metaphyseal fractures, and certain diaphyseal fractures such as in the forearm. Since the 1960s, both the techniques and implants used for internal fixation with plates have evolved to provide for improved healing. Most recently, plating methods have focused on the principles of 'biological fixation'. These methods attempt to preserve the blood supply to improve the rate of fracture healing, decrease the need for bone grafting, and decrease the incidence of infection and re-fracture. The purpose of this article is to provide a brief overview of the history of plate osteosynthesis as it relates to the development of the latest minimally invasive surgical techniques.