The effects of implant composition on extensor tenosynovitis in a canine distal radius fracture model.
OBJECTIVE
Dorsal plating of distal radius fractures with titanium plates has resulted in clinically observed tenosynovitis and tendon rupture. The goal of this study was to investigate whether titanium-based implants result in more extensor tendon inflammation than matched stainless-steel implants in a canine fracture model.


METHODS
An osteotomy was created in the distal radius of 18 beagles and fixed with 2.7-mm 4-hole plates composed of commercially pure titanium, titanium alloy (Ti-Al6-V4), or 316L stainless steel. Animals were killed at an average of 4 months. Tendon gliding was assessed by applying a force at the extensor musculotendinous junction and noting gliding. Histologic grading (mild, moderate, severe) was based on cellular hypertrophy, hyperplasia, and leukocytic infiltration.


RESULTS
Tendons glided freely in 100% stainless-steel specimens, 75% of titanium alloy, and 43% of commercially pure titanium groups. A severe inflammatory reaction was identified in 60% of the titanium alloy (Ti-A16-V4) group, 57% of the pure titanium group, and 0% of the stainless-steel group.


CONCLUSIONS
Dorsal plating of the canine radius with commercially pure titanium or titanium alloy implants produced a greater inflammatory peritendinous response than matched stainless-steel implants.
Sinicropi
Stefano M
SM
Trauma Training Center, New York Orthopedic Hospital, New York, NY 10032, USA.
Su
Brian W
BW
Raia
Frank J
FJ
Parisien
May
M
Strauch
Robert J
RJ
Rosenwasser
Melvin P
MP
D000497:Alloys; D000818:Animals; D001860:Bone Plates; D004285:Dogs; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal; D023421:Models, Animal; D010027:Osteotomy; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013193:Stainless Steel; D013710:Tendons / Q000502:physiology; D013717:Tenosynovitis / Q000209:etiology / Q000473:pathology*; D014025:Titanium
D000497:Alloys; D013193:Stainless Steel; D014025:Titanium