Periprosthetic infections resulting from bacterial biofilm formation following surgical bone fracture fixation present important clinical challenges. Conventional orthopedic implant materials, such as titanium, are prone to biofilm formation. This study introduces a novel surface for orthopedic titanium plates, optimized for clinical application in human bone fractures. Leveraging nanostructure-based surface coating technology, the plate achieves an antibacterial/immunonegative surface using biocompatible materials, including poloxamer 407, epigallocatechin gallate, and octanoic acid. These materials demonstrate high biocompatibility and thermal stability after autoclaving. The developed plate, named antibacterial immunonegative surface, releases antibacterial agents and prevents adhesion between human tissue and metal surfaces. Antibacterial immunonegative surface plates exhibit low cell toxicity, robust antibacterial effects against pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa , high resistance to biofilm formation on the implant surface and surrounding tissues, and minimal immune reaction in a rabbit femoral fracture model. This innovation holds promise for addressing periprosthetic infections and improving the performance of orthopedic implants., Competing Interests: Competing interests: J.-W.L., C.-H.L., and S.J.K. wish to disclose a potential conflict of interest (patents pending KR-10-2022-0138875, KR-10-2022-0138876, KR-10-2022-0138877, KR-10-2022-0138878, and awarded KR-10-2543199). The authors acknowledge that these planned patents could be seen as a conflict of interest, as the technology is directly related to the research presented here., (Copyright © 2024 Jeong-Won Le et al.)