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Distal Radius Fractures and Titanium Volar Plates: Should We Take the Plates Out?

      Outcomes are generally good after locked volar plating for the internal fixation of fractures of the distal radius.
      • Orbay J.L.
      • Fernandez D.L.
      Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient.
      As such, the implants are removed infrequently, usually for cases of dorsal or volar tendon irritation or rupture, or because improper position of the distal pegs or screws is appreciated after surgery.
      • Rozental T.D.
      • Blazar P.E.
      Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius.
      It is not known if there are potential side effects to having implanted titanium plates and screws over the long term. Although there are rare reports of sarcomas or osteosarcomas occurring in the region of total joint arthroplasties or dental implants that contain titanium,
      • Adams J.E.
      • Jaffe K.A.
      • Lemons J.E.
      • Siegal G.P.
      Prosthetic implant associated sarcomas: a case report emphasizing surface evaluation and spectroscopic trace metal analysis.
      • McGuff H.S.
      • Heim-Hall J.
      • Holsinger F.C.
      • Jones A.A.
      • O'Dell D.S.
      • Hafemeister A.C.
      Maxillary osteosarcoma associated with a dental implant: report of a case and review of the literature regarding implant-related sarcomas.
      • Sunderman Jr, F.W.
      Carcinogenicity of metal alloys in orthopedic prostheses: clinical and experimental studies.
      animal studies suggest that titanium has a low risk of carcinogenicity.
      • Lewis G.G.
      • Belniak R.M.
      • Plowman M.C.
      • Hopfer S.M.
      • Knight J.A.
      • Sunderman Jr, F.W.
      Intraarticular carcinogenesis bioassays of CoCrMo and TiAIV alloys in rats.
      • Takamura K.
      • Hayashi K.
      • Ishinishi N.
      • Yamada T.
      • Sugioka Y.
      Evaluation of carcinogenicity and chronic toxicity associated with orthopedic implants in mice.
      Currently, there are no published studies that report on the serum level of titanium after volar plating of distal radius fractures. Given the current wave of enthusiasm regarding the implantation of these plates, it remains unclear whether or not these implants should be left in place for a long period of time.
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