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Can Titanium Plates Be Left in the Body Safely?

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 bone. 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.


Reference:



David G. Dennison, MD. Distal Radius Fractures and Titanium Volar Plates: Should We Take the Plates Out? In The Journal of Hand Surgery. January 2010. Vol. 35A. No. 1. Pp. 141-143.



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I hope to God that I am never in a serious accident where I am hauled off, unconscious, to emergency surgery and have this junk put in my body. May god bless us all that this never happens to us. That would be a total negation of all our efforts! I wonder if Howard Hughes was the victim of this after his serious aviation accident. That might explain his many eccentricities.

[quote=Marc]


Adult

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Arm (Humerus)
Children's Orthopedics
Elbow
Foot
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Can Titanium Plates Be Left in the Body Safely?[quote]
--------
Marc, You are really getting into some heavy questioning here. This is what I found, you may look into.METAL TOXICITY TESTING=

<http://www.testyourintoleranceusa.com/Metal-Toxicity-Test.html>

Hope this helps. This forum is basically for Mercury Detox/Amalgam Fillings. You can go on the internet and click on several possibilitites for this. I went to Toxity from surgical metal plates in body.
Russ may come in later. He has been quite busy.

Although the forum is for dental mercury poisoning. I think that it is important to be aware of all "medically induced" heavy metal poisoning as it affects us in the same way. Just like a post I put here earlier about the aluminum in baking powder and some baking soda in which Russ responded to. If we limit our awareness to only the fillings in our teeth, we are not helping people 100%. Metal detox is metal detox regardless of where it comes from. And if people don't realize other causes, they may be detoxing in vain!

Hello Marc,
Yes, I did read some time back when you posted about aluminum. And you are correct that mercury is NOT only found in amalgams. But perhaps we need another forum title for those that are interested in the toxicity of other metals, etc, other than for amalgams. So you understand why I posted the reply as I did?

There's no sense in getting upset over this with the exclamation point, etc. I've been posting on this forum for over 5 years, altough most of my time is on the Bible Forum. Russ has given me permission to post/reply to anyone, anytime. WHY? Because he is busy, and I am trying to help. That's why, Marc, I took the time to find other places on the internet that you could go for the questions you posted. It was not in anyway to offend you.
I also have amalgams and know all the harm they cause. I suffer myself with many of them. I use the DMSA, Vit D, Yeast/Fungal Detox, and the Algin, to help ward off the effects.

Now, Marc, as I said, Russ is a very busy man. He's on line almost 24/7's Bless his heart. He not only is on this forum but is helping others on another place. AND THAT IS A BIG BUSY PLACE! So let's be kind and I'll see to it that he reads your lengthy list. This place is specifically for amalgam fillings, as is Titled.

Maybe you can post in the "General Health Conditions" or "Diseases and Conditions" about the other metals toxicities? You'd still be helping people. Scroll down some and you'll find both of them. How's that? Have a good evening.

I'm sorry if you misunderstood my mood. I am not upset. An exclamation has other connotations. And although I appreciate the token gesture of your finding that information, it is not for me because I know where to find it. My post was for the benefit of the other forum members. I pointed out the other post as an example. I don't necessarily need Russ's response, although his input is always appreciated and respected- so it is his choice. As a bit of advice, for whatever it is worth, It may not be good to overly fragment the forum with too many categories as some topics fall underneath the same umbrella. After all, this category is about detoxing. If someone removes their fillings and does "detox" , they will just be spinning their wheels if they don't realize that the steel (or titanium) rod they had put in their leg ten years ago to fix a broken bone could be just as big of a problem. Just my two cents.