Risk factors of titanium locking plate osteosynthesis

Introduction. Titanium plates with angular-stable locking screws are today preferred by most trauma surgeons for the internal fixation. We examined two cases which progressed to delayed consolidation and implant damage. Material and methods. Two titanium implants were analyzed in terms of chemical composition and hardness. For comparison, two locked plates used to consolidate fractures similar in terms of location and complexity were studied. Results. Chemical analysis showed that the broken plates were made of titanium with a purity exceeding 99.5% and 98.7% Mechanical test results indicated that premature breakage is the result of excessive hardness. Discussions. Damage to implants used to treat distal femoral and tibial pilon fractures is a serious complication that prolongs time to healing and requires surgical revision Our results demonstrate that the locking plates made of commercially pure titanium, characterized by high hardness of the material, are susceptible to breakage if bone consolidation is delayed.