In 54 patients fractures of the long bones were stabilized with limited-contact dynamic compression plates (LC-DCP) made of titanium. The implant surfaces were anodized to an interference colour of gold. The surface morphology effects the tissue response to the implant and was therefore examined. At implant retrieval, about 18 months post operatively (range 11 to 27), samples of the soft tissue layer covering the plate were excised and analysed by histomorphometrical means. The aim was to study the soft tissue reactions at the implant site and further to correlate itto the clinical symptoms of the patients. At retrieval the plates were covered by a connective tissue layer of 2 mm thickness on average. In patients with local pain a comparatively significant higher number of round cells (p=0.001) and macrophages (p=0.01) was found. This is consistent with a chronic granulomatous inflammatory reaction. The localized tissue discoloration observed in about half of the patients was confirmed as being due to titanium, but it was not the focus of a cellular reaction and was not correlated with pain. In general the implant showed good biocompatibility with excellent or good clinical results in 96% of patients.

A 42-year-old man was referred to the Department of Orthopedic Surgery with pain over his right greater trochanter and signs of systemic infection. CT showed an enhanced mass in his gluteus maximus as well as gas in the biceps femoris over the underlying hip joint. Tissue biopsy yielded Fusobacterium nucleatum and Actinomyces turicensis. The patient was successfully treated for 6 weeks with amoxicillin/clavulanic acid 875mg/125mg and metronidazole 500mg.