Rational Utilization of the Stress Shielding Effect of Implants



Fracture healing is an extremely complicated biological process. The primary factor affecting fracture healing is the blood supply to the fracture site, which is the basic assurance of successful treatment, and as well as sustained blood supply to the fracture site, a favorable local mechanical environment is also an essential requirement for fracture healing. Research in past years has shown that the mechanical environment favorable to fracture healing includes two aspects: stability of the fracture ends (exclusion of harmful movement and shear stress) and stimulation of physiological stress. In the past, clinical treatment of fractures focused on the means to ensure the stability of the fracture ends, while modern treatment for fracture gives more regard to the physiological requirements for fracture healing.


Shape Memory Internal Fixation Fracture Healing Fracture Site Intramedullary Nail 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Chen YQ, Dai KR, Qiu SJ, Zhu ZA. Bone remodeling after internal fixation with different stiffness plates: Ultra-structural investigation. Chinese Med J 1994; 107: 766–70.Google Scholar
  2. 2.
    Wang Y, Dai KR. Effect of internal fixation plates on microcirculation in under-plate cortical bones: microangiography and scanning electron microscopy. Chinese Med J 1994;107:929–33.Google Scholar
  3. 3.
    Zhu ZA, Dai KR, Qiu SJ. Repair of regional osteoporosis after removal of rigid fixing plate: an experimental investigation. Chinese Med J 1994;107:364–7.Google Scholar
  4. 4.
    O’Sullivan ME, Chao EY, Kelly PJ. The effects of fixation on fracture healing. J Bone Joint Surg 1989;71(A): 306–10.PubMedGoogle Scholar
  5. 5.
    Zimmerman M. The design and analysis of a laminated partially degradable composite bone plate for fracture fixation. J Biomed Res 1987;21(Suppl):345–61.Google Scholar
  6. 6.
    Hanafusa S, Matsusue Y, Yasunaga T,O, Ka M, Shi Kinami Y, I, Kada Y. Biodegradable plate fixation of rabbit femoral shaft osteostomies. Clin Orthop 1995; 315:262–71.PubMedGoogle Scholar
  7. 7.
    Strycker ML. Biodegradable internal fixation. J Foot Ankle Surg 1995;34:82–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Korvick DL, Newbrey JW, Bagby GW, Pettit GD, Lincoln JD. Stress shielding reduced by a silicon plate bone interface. Acta Orthop Scand 1989;60:611–16.PubMedCrossRefGoogle Scholar
  9. 9.
    Tomita N, Kutsuna T. Experimental studies on the use of a cushioned plate for internal fixation. Int Orthop 1987;11:135–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Jasmine MS, Dahners LE, Gilbert JA. Reduction of stress shielding beneath a bone plate by use of a polymeric underplate. Clin Orthop 1989;246:293–9.PubMedGoogle Scholar
  11. 11.
    Kostopoulos V, Vellios L, Fortis AP, Panagiotopoulos E, Milis Z, Lambiris E. Comparative study of callus performance achieved by rigid and sliding plate osteosynthesis based upon dynamic mechanical analysis. J Med Eng Technol 1994;18:61–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Tang TT, Dai KR, Xue WD. Mechanical analysis of reaction of changing-stiffness plate to cyclic vertical compressive loading. J Appl Biomech 1996;11(1):42–6.Google Scholar
  13. 13.
    Dai M, Dai KR, Qiu SJ. The effects of stress-relaxation plate on bone remodeling: an experimental study. Chinese J Surg 1995;33:698–700.Google Scholar
  14. 14.
    Dai KR, Dai Min, Wang KY, Xue WD. The influence of stress-relaxation plate on the geometry configuration and mechanical property of bone: an experimental study. Chinese J Med 1995;75:414–16.Google Scholar
  15. 15.
    Zhang XL, Dai KR, Tang TT. The influence of stress-relaxation plate on collagen gene expression and cellular ultrastructure of fracture healing. Chinese J Orthop 2000;20(6):362–5.Google Scholar
  16. 16.
    Zhang XL, Dai KR, Tang TT. Effects of stress-relaxation plate on the disorganization and reparation of regional bone structure. Acta Univ Med Second Shanghai 2000; 20(6):488–90.Google Scholar
  17. 17.
    Dai M, Dai KR. An experimental study of the effect of stress-relaxation plate fixation on cortical bone microcirculation. Chinese J Orthop 1998;18(8):484–7.Google Scholar
  18. 18.
    Zu XS, Dai KR, Wu XT, Xu XL, Xue WD. Investigation on stability of shape memory sawtooth-arm embracing internal fixator. J Appl Biomech 1995;10(2):40–6.Google Scholar
  19. 19.
    Dai KR, Wu XT, Zu XS. An investigation of the selective stress-shielding effect of shape-memory sawtooth-arm embracing fixator. Mater Sci Forum 2002; 394–395:17–24.CrossRefGoogle Scholar
  20. 20.
    Dai KR, Ni C, Wu XT, Qiu SJ, Xu XL, Zhu XS. An experimental study and preliminary clinical report of shape-memory sawtooth-arm embracing internal fixator. Chin J Surg 1994;32:629–32.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2004

Authors and Affiliations

  • K. Dai

There are no affiliations available

Personalised recommendations