INFECTION AFTER OPEN REDUCTION AND INTERNAL-FIXATION WITH DYNAMIC COMPRESSION PLATES - CLINICAL AND EXPERIMENTAL-DATA

Infection rates for open reduction and internal fixation (ORIF) with t he DCP in clinical studies are based on heterogeneous data on general risk factors and do not take into account the direct effect of the imp lant (material, design, surface, technique). The initial degree of bac terial contamination is generally unknown and the applied definition o f the term infection is not mentioned. In our own prospective, randomi zed clinical study including 281 cases of ORIF with the DCP (154 steel vs 127 titanium), the influence of the implant material on susceptibi lity to local infection was examined in relation to initial bacterial contamination (109 non-contaminated/172 contaminated). Although in the group of contaminated DCPs the difference in the infection rates for stainless steel (sSt) and commercially pure titanium (cpTi) showed no statistical significance, a tendency was apparent. In an animal experi ment, the lower rates of infection for c.p.Ti-DCP compared to sSt-DCP in the presence of a local bacterial challenge could be demonstrated w ith statistical significance. The need for further experimental resear ch in the field of implant related local infection after ORIF will be discussed and strategies for further investigations proposed.