Patients who have metal plates, pins, and screws in the body are rightfully concerned about the safety and long-term effects of these devices left inside. Surgeons share those concerns but do not want to perform an additional surgery to remove them if unnecessary. And sometimes when plates are used to hold bone together after a fracture, bone grows around them embedding this fixation device too much to remove it easily.
Titanium has replaced stainless steel these days for fixation devices. It is more compatible with the human biology, which means it’s less likely to cause a reaction. When an inflammatory response does occur, it is mild and limited (doesn’t last). Titanium can also be combined with other metals such as cobalt, chromium, and molybdenum to create a lighter but more durable material.
There are all kinds of concerns about metal plates. Animal studies show there is an effect on the immune system. There is evidence that the metal can cause the entire immune system to be suppressed (under functioning). This immune system shut down could result in infections. Some studies have shown that metal implants can cause an increase in white blood cells called lymphocyte reactivity. There is a worry that this effect could cause implant loosening or failure, though it hasn’t been proven yet.
Volar plates refer to the location of fixation devices — placed on the front or inside of the forearm. Radius fracture tells us the radial bone in the forearm is broken. There are two bones in the forearm: ulna and radius. The radius is on the thumb-side of the forearm. Distal means the break is down toward the hand rather than up by the elbow.
There are all kinds of concerns about metal plates. Animal studies show there is an effect on the immune system. There is evidence that the metal can cause the entire immune system to be suppressed (under functioning). This immune system shut down could result in infections. Some studies have shown that metal implants can cause an increase in white blood cells called lymphocyte reactivity. There is a worry that this effect could cause implant loosening or failure, though it hasn’t been proven yet.
Removing titanium plates does slowly reduce the levels of metal in the blood and soft tissues. But it can take a year or more after removal to bring these elevated levels back down to normal. Dr. Dennison reports that there aren’t specific studies of the effects of titanium plates (prolonged use or removal) from the treatment of distal volar radial fractures.
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