Influence of implant material and surface on infection susceptibility with locked internal fracture fixation plates

+Moriarty, T F; Debefve, L; Boure, L; 1, Richards, R G. +AO Research Institute, Davos, Switzerland, 2 Cardiff School of Biosciences, Cardiff University, Wales. Senior author [email protected] Introduction: Polishing the surface of internal fracture fixation (IFF) devices composed of titanium (Ti) or titanium aluminium niobium (TAN) has been found to reduce soft tissue adhesion and bony overgrowth 3 in animal studies. Thus, polishing the surface of IFF devices is expected to have significant clinical benefit in situations where the device is to be removed or where tissues (such as tendons) need to glide over the device. However, the effect of polishing the surface of IFF devices on susceptibility to infection remains unknown. Animal studies have found that in conventional IFF plates (dynamic compression plates, DCPs), electropolished stainless steel (EPSS) is associated with an increased susceptibility to infection in comparison with standard non-polished Ti. It is not clear, however, if this is due to improved bioperformance of Ti over steel or improved performance of a standard, non-polished microrough surface over an electropolished surface. It has also been shown that locked IFF plates (made of Ti) have greatly reduced susceptibility compared to compression plates (made of Ti) which may be due to their minimizing periosteal damage. The aim of the present study was to determine the effect of polishing locked Ti and TAN IFF plates (Locking Compression Plates (LCPs)) on susceptibility to infection in comparison with standard microrough equivalents and EPSS polished control. This is the first study to compare Ti and EPSS IFF plates of the same design, both with polished surfaces, upon infection resistance. The study will also determine if polishing affects infection resistance of Ti and TAN IFF plates.