Orthopaedic metallic implants in extremity fractures and contact allergy

Because of reports of sensitization and/or elicitation of contact allergy to orthopaedic metallic implants we performed a prospective study in 60 patients operated for extremity fractures. The implants, consisting of plates, screws, wires, pins and staples, were all made of stainless steel. The patients were tested epicutaneously and intracutaneously with nickel, cobalt and chromium within 2 days of surgery and one year later. It was possible to retest and evaluate 48 patients (80%). Of these 48 patients three were tested positive to nickel at the primary testing; they were also positive at the secondary testing. The remaining 45 patients were all negative to the three metals at both test occasions. There were no dermatologic or orthopaedic complications due to the materials used. The present prospective study did not reveal any cases of contact allergy or dermatitis as a consequence of metallic bioimplants in the treatment of extremity fractures.