Thomsen M, Thomas P
Klinik für Orthopädie und Unfallchirurgie, Klinikum Mittelbaden, Balger Strasse 50, 76532, Baden-Baden, Deutschland.
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilans-Universität München, München, Deutschland.
Unfallchirurg. 2017 Feb;120(2):116-121. doi: 10.1007/s00113-016-0309-7.
Metal implants for osteosynthesis are nowadays standard in orthopedic and trauma surgery. Steel implants, especially cerclages, bands and wires, can show more corrosion due to friction and lead to encapsulation in connective tissue with fluid borders even without loosening. Corrosion and fluid borders are potentially more susceptible to incompatibility and infections. Titanium implants have the advantage of better allergic compatibility. Problems may occur in material removal, especially with titanium implants because material fractures occur more frequently. Particularly with fixed angle constructions, the blocking of titanium-titanium bonding and/or screws in bone can occur by adhesion and ingrowth. Apart from single case reports there is no evidence that modern steel implants cause more allergic reactions than titanium; therefore, in the treatment by osteosynthesis the stability, risk of loosening, manifestation of allergies and the possibility of material removal must always be considered.
用于骨固定的金属植入物如今在骨科和创伤外科手术中已成为标准。钢制植入物,尤其是环扎带、束带和金属丝,由于摩擦可能会出现更多腐蚀,即使在没有松动的情况下也会导致在结缔组织中形成有液体边界的包裹。腐蚀和液体边界可能更容易出现不相容性和感染问题。钛植入物具有更好的过敏相容性优势。在取出材料时可能会出现问题,特别是对于钛植入物,因为材料断裂更频繁发生。特别是在固定角度结构中,钛 - 钛结合处和/或骨内螺钉可能会因粘连和向内生长而受阻。除了个别病例报告外,没有证据表明现代钢制植入物比钛植入物会引起更多过敏反应;因此,在骨固定治疗中,必须始终考虑稳定性、松动风险、过敏表现以及材料取出的可能性。