Mixing Implants of Differing Metallic Composition in the Treatment of Upper-extremity Fractures

Abstract

Mixing implants with differing metallic compositions has been avoided for fear of galvanic corrosion and subsequent failure of the implants and of bone healing. The purpose of this study was to evaluate upper-extremity fractures treated with open reduction and internal fixation with metallic implants that differed in metallic composition placed on the same bone. The authors studied the effects of using both stainless steel and titanium implants on fracture healing, implant failure, and other complications associated with this method of fixation. Their hypothesis was that combining these metals on the same bone would not cause clinically significant nonunions or undo clinical effects from galvanic corrosion. A retrospective review was performed of 17 patients with upper-extremity fractures fixed with metal implants of differing metallic compositions. The primary endpoint was fracture union. Eight clavicles, 2 proximal humeri, 3 distal humeri, 3 olecranons, and 1 glenoid fracture with an average follow-up 10 months were reviewed. All fractures healed. One patient experienced screw backout, which did not affect healing. This study implies that mixing implants with differing metallic compositions on the same bone for the treatment of fractures does not adversely affect bone healing. No evidence existed of corrosion or an increase in complications with this method of treatment. Contrary to prior belief, small modular hand stainless steel plates can be used to assist in reduction of smaller fracture fragments in combination with anatomic titanium plates to obtain anatomic reduction of the fracture without adversely affecting healing.

3D Biomimetic Porous Titanium (Ti6Al4V ELI) Scaffolds for Large Bone Critical Defect Reconstruction: An Experimental Study in Sheep

“…The reconstruction of large bone defects has traditionally been achieved by the use of resorbable bone substitutes [ 14 , 26 ] or permanent metallic prosthetic implants [ 15 , 18 , 19 ]. Unlike bone substitutes, which cannot hold the load bearing, metal prosthetic implants allow early functional recovery.…”

“…Compared to titanium implants, stainless steels exhibit a lower strength and corrosion resistance and a greater ductility and stiffness. Their high stiffness makes stainless-steel implants inferior to titanium ones in bone replacement applications [ 15 ]. Currently, titanium is the most used metallic biomaterial due to its biocompatibility, resistance to the corrosive activity of the body, and its specific force related to its traction force and rigidity.…”

Pseudarthrosis due to galvanic corrosion presenting as subarachnoid hemorrhage

“…The clinical application of this phenomenon is not agreed on in the scientific community, as many clinical studies have not shown galvanic corrosion of mixed metals to be clinically significant. [456] This report, however, argues otherwise.…”

Mechanical and microstructural properties of fixation systems used in oral and maxillofacial surgery

“…Despite fixation systems are made of different metallic compositions, if the corrosion were of real clinical concern, more complications would have occurred related to the dissimilar metals in the same biological milieu [21]. Furthermore, the current flowing through the galvanic couple is very low [22].…”