Effects of implant material and plate design on tendon function and morphology.

Abstract:

:Titanium implants are an alternative to stainless steel implants for internal fixation after fracture. The advantages of titanium include decreased implant stiffness, increased bio-compatibility, and diminished stress shielding. However, titanium has been implicated in tendon irritation and adhesions when used in the hand and wrist. We evaluated the relationship between extensor tendon morphology and dorsal plating of the distal radius in a canine model using distal radius pi plates made of stainless steel, titanium, and titanium alloy with a modified ramped edge design. We found marked histologic changes in the tendons and surrounding soft tissues including tendon deformation and degeneration (fibrillation, cartilage metaplasia, hypocellularity and hyalinization of blood vessels), peritendonous adhesions and neovascularity in the parenchyma. Only a minimal inflammatory cell infiltrate was identified and was limited to the tenosynovium and/or paratenon. No differences were identified between titanium and stainless steel implants and those with a ramped design. Although all animals lost wrist motion with time, no differences were observed between groups. Our results suggest that pi plate placement on the dorsal surface of the distal radius may lead to extensor tendon irritation and dysfunction. There is no evidence to suggest that this is specifically related to titanium or plate edge design.

journal_name

Clin Orthop Relat Res

authors

Cohen MS,Turner TM,Urban RM

doi

10.1097/01.blo.0000205894.98361.29

subject

Has Abstract

pub_date

2006-04-01 00:00:00

pages

81-90

eissn

0009-921X

issn

1528-1132

pii

00003086-200604000-00013

journal_volume

445

pub_type

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