title: Results of titanium locking plate and stainless steel cerclage wire combination in femoral fractures.
abstract: BACKGROUND
  Some in vitro studies warn combining different metals in orthopedic surgery. The aim of this study is to determine the impact of combining titanium and stainless steel on bone healing and the clinical course of patients undergoing internal fixation of femoral fractures.
  
  
  METHODS
  69 patients with femoral fractures had polyaxial locking plate osteosynthesis. The locking plate was made of a titanium alloy. Two different cohorts were defined: (a) sole plating and (b) additional stainless steel cerclage wiring. Postoperative radiographs and clinical followup were performed at 6 weeks, 3 months and 12 months.
  
  
  RESULTS
  Cohorts A and B had 36 and 33 patients, respectively. Patient demographics and comorbidities were similar in both groups. In two cases in cohort A, surgical revision was necessary. No complication could be attributed to the combination of titanium and stainless steel.
  
  
  CONCLUSIONS
  The combination of stainless steel cerclage wires and titanium plates does not compromise fracture healing or the postoperative clinical course.
authors.affiliation: Department of Orthopaedics, Hand and Reconstructive Surgery, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
authors.forename: Bilal Farouk
authors.initials: BF
authors.lastname: El-Zayat
authors.forename: Steffen
authors.initials: S
authors.lastname: Ruchholtz
authors.forename: Turgay
authors.initials: T
authors.lastname: Efe
authors.forename: Jürgen
authors.initials: J
authors.lastname: Paletta
authors.forename: Dimitri
authors.initials: D
authors.lastname: Kreslo
authors.forename: Ralph
authors.initials: R
authors.lastname: Zettl
keywords: Cerclage wire; fracture healing; galvanic corrosion; locking plate; stainless steel; titanium