Evolution of plate design and material composition.

The evolution of plate fixation of fracture was accompanied by advances in metallurgy and improvement in understanding of the requirements for successful fracture healing. Locked internal fixation minimizes biologic damage and when used in conjunction with minimally invasive approaches may optimize fracture healing. Some current metal locked plate constructs may actually be too stiff, and various methods including screw modification, plate hole modification, and changes in plate material composition may provide a solution to optimize fracture healing. This paper reviews the evolution of plate design and describes the early clinical experience with the use of carbon fibre reinforced reinforced polyetheretherketone composite plates.