Infection after open reduction and internal fixation with dynamic compression plates--clinical and experimental data

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Infectious Disease

Background:

• Current infection rate data for open reduction and internal fixation (ORIF) lack specificity regarding implant material effects.
• Existing studies often use heterogeneous data and do not account for initial bacterial contamination or precise infection definitions.

Purpose of the Study:

• To evaluate the influence of implant material (stainless steel vs. titanium) on local infection susceptibility during ORIF.
• To assess the impact of initial bacterial contamination on infection rates associated with different implant materials.

Main Methods:

• Prospective randomized clinical study of 281 ORIF cases comparing stainless steel (sSt) and commercially pure titanium (cpTi) dynamic compression plates (DCPs).
• Analysis of infection rates based on implant material and initial bacterial contamination status (contaminated vs. non-contaminated).
• Animal experiments to validate findings on infection rates between sSt-DCP and cpTi-DCP under bacterial challenge.

Main Results:

• In clinical trials with contaminated DCPs, titanium showed a trend towards lower infection rates than stainless steel, though not statistically significant.
• Animal experiments demonstrated a statistically significant lower infection rate for cpTi-DCP compared to sSt-DCP when exposed to local bacteria.

Conclusions:

• Implant material may influence local infection risk following ORIF, with titanium potentially offering an advantage.
• Further experimental research is needed to elucidate the mechanisms of implant-related infections and develop targeted prevention strategies.