mydeepestsecret Posted August 17, 2013 Share Posted August 17, 2013 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. So just how safe are these devices? In this article, Dr. David G. Dennison from the Orthopedic Surgery department of Mayo Clinic in Rochester, Minnesota summarizes what we know from research and clinical studies on this topic. In particular, Dr. Dennison zeroes in on titanium volar plates used to treat distal radius fractures. 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. 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. Another potential problem with titanium plates is the debris that occurs. Tiny flakes of this metal chip off and enter the bloodstream, nearby soft tissues, and/or joint. Both titanium and stainless steel have been found in all these anatomical areas of the human body (titanium slightly more often and in greater amounts than stainless steel). Metal debris is more likely to develop when the implant is rubbing against another surface. This wearing or rubbing phenomenon is called fretting. Then the question arises: can this metal debris lead to the formation of cancer? Studies in mice show there is the potential for metal wear debris to damage chromosomes making it a potential carcinogen (cancer producing). Next, developers of these products asked if coating the plate would protect the body from corrosion or metal debris? This question remains unanswered so far. One thing we do know from studies -- placing a long titanium or metal pin down through the middle of a bone to stabilize it is linked with a much higher increase in the amount of metal found in the bloodstream. Chromium seems to have the highest levels reported for these intramedullary nails. Intramedullary titanium nails also increase the amount of titanium found in blood samples, but not as much as chromium. Evidently, the large surface area of the intramedullary nail exposes the bone to more titanium, thus the higher levels of serum (blood) metal. 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. Summarizing, Dr. Dennison says that the information found on this topic seems to suggest that the overall level of risk when leaving titanium plates in the forearm is acceptable. The volar surface plate is not a large implant and doesn't usually involve nails down through the . Instead, small screws placed perpendicular to the plate to hold it in place are more typical. Still, there are concerns and risks reported that deserve specific study and more conclusive answers. Future studies are needed to address these concerns and questions.http://www.eorthopod.com/content/can-titanium-plates-be-left-in-the-body-safely Link to comment Share on other sites More sharing options...
mydeepestsecret Posted August 17, 2013 Author Share Posted August 17, 2013 something t hat i have found during my research and thought of sharing. im interested in facial contouring without the use of titanium screws for fixation. unfortunately most clinics use screws which can be dangerous in the long run. Link to comment Share on other sites More sharing options...
alfenzel Posted September 2, 2013 Share Posted September 2, 2013 thank you for this information i also want to have plastic surgery but i am afraid for the long run, what happen when you have things done when you get old? :s...i dont want to look ugly or get cancer when i get older xD Link to comment Share on other sites More sharing options...
endymion Posted September 3, 2013 Share Posted September 3, 2013 That's a big concern for me too... I'm thinking about getting a zygoma reduction. I have read about a published academic article on zygoma bone malunion after reduction surgery and those cases freaked me out... severe facial sagging+bone misplacement. Since i don't want permanent metal screws inside my body either,I have been looking into clinics that use melting screw for bone fixation but the only clinic i have found so far is banobagi. Link to comment Share on other sites More sharing options...
winterntht Posted September 3, 2013 Share Posted September 3, 2013 Is it possible for you to tell me the details of the article (journal name, issue number and page) please? Link to comment Share on other sites More sharing options...
endymion Posted September 3, 2013 Share Posted September 3, 2013 Journal of Plastic, Reconstructive & Aesthetic Surgery (2012) 65, 448-455 The title is Three-dimensional assessment of zygomatic malunion using computed tomography in patients with cheek ptosis caused by reduction malarplasty. Link to comment Share on other sites More sharing options...
saphireeni Posted September 4, 2013 Share Posted September 4, 2013 Wish I'd come across this info before getting my chin augmentation... Never had acne all my life, but now I have breakouts... I wonder if it's related. Too scared to get them removed. Does anyone know somebody who had them removed? Link to comment Share on other sites More sharing options...
endymion Posted September 4, 2013 Share Posted September 4, 2013 Don't scare yourself. Adverse reaction to titanium is rare. Talk to your doctor first before you think about removing them. Link to comment Share on other sites More sharing options...
shinyglittery Posted September 4, 2013 Share Posted September 4, 2013 I wasn't scared of this before but now I'm worried thanks a lot it's good information but it doesn't help me, I'm going to get the surgeries done no matter what and it's not like I'll find some magical doctor who does it all without titanium... Link to comment Share on other sites More sharing options...
xiongs Posted September 17, 2013 Share Posted September 17, 2013 the only ones i heard use screws said they dissolve after a long while. if you don't believe them maybe you can trick them into saying that youre going to get an mri and it will rip out haha Link to comment Share on other sites More sharing options...
shinyglittery Posted September 17, 2013 Share Posted September 17, 2013 except titanium isn't magnetic... xD Link to comment Share on other sites More sharing options...
donatello Posted January 25, 2014 Share Posted January 25, 2014 Do all v line surgeries require screws I think in the long run its should ok. I know alot of pole how have titanium rods from back and angle and bone break operations... Link to comment Share on other sites More sharing options...
desiree24 Posted January 28, 2014 Share Posted January 28, 2014 Thanks for sharing info. Link to comment Share on other sites More sharing options...
emporio Posted March 15, 2014 Share Posted March 15, 2014 This is why I am really turned off by the idea of having a genioplasy to bring my chin forward. Link to comment Share on other sites More sharing options...
paxsky Posted March 16, 2014 Share Posted March 16, 2014 Everm claims to use them for 2-jaw surgery; not sure about zygomatic surgery... Link to comment Share on other sites More sharing options...
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