[Compatibility and allergies of osteosynthesis materials]

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.