A comparison of the effect of open intramedullary nailing and compression-plate fixation on fracture-site blood flow and fracture union

We compared the effects of compression-plating and open intramedullary nailing after reaming on the vascular supply to a standard fracture site, on the rate of fracture union, and on the biomechanical quality of bone after union in dogs. The proper location of a compression plate in relation to the periosteum also was investigated. Bone blood flow reached higher levels and remained elevated longer in fractures that were fixed with a rod than in those fixed with plate. Rod-fixed fractures healed by periosteal callus, whereas, plate-fixed fractures healed by endosteal callus. The fracture gained mechanical strength more slowly in the rod-fixed group than in the plate-fixed group. Subperiosteal or extraperiosteal placement of a plate revealed similar effects on bone-healing.