Trace metal analysis following locked volar plating for unstable fractures of the distal radius

An increase in the utilization of metallic devices for orthopaedic interventions from joint replacement to fracture fixation has raised concern over local metal ion release and possible systemic sequelae due to dissemination of these ions. Our purpose was to determine whether serum titanium concentrations were elevated in patients who had previously received a locked volar distal radius plate. Our hypothesis was that the simple presence of titanium alone in a relatively fixed implant was not enough to raise serum titanium levels. Twenty-two potential subjects who had received a volar locked distal radius plate were identified through review of a single surgeon's operative logs. Eleven met inclusion criteria. Serum titanium levels were measured in these subjects and compared to both current and historical control groups. We found no difference between controls and our study group with the exception of one control subject who is employed as a welder. This is in contrast to previous studies from our institution which found increases in titanium levels in hip and spine implants. We conclude that a locking titanium volar distal radius plate does not raise serum titanium levels in this population.