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Galvanic reactions between cerclage wires and Kuntscher nails
1Royal Orthopaedic Hospital, Northfield, Birmingham, UK.
Abstract:
Four patients are presented who had closed femoral shaft fractures and developed either extensive callus or osteomyelitis following open Kuntscher nailing and cerclage wiring of a butterfly fragment. Both the Kuntscher nail and cerclage wire are made of stainless steel but with different percentages of constituent elements. We looked at the galvanic reactions between the two and showed potential differences of up to 4.5 m.v. in wound drainage fluid. Potential differences in this range have been reported in other studies to be associated with extensive callus and infections associated with stainless steel anode corrosion.
Insights
Galvanic reactions between stainless steel implants, like Kuntscher nails and cerclage wires, may cause complications. Potential differences in wound fluid are linked to extensive callus and osteomyelitis in femoral fractures.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Infectious disease
Background:
- Femoral shaft fractures are common orthopedic injuries.
- Kuntscher nailing and cerclage wiring are surgical techniques used for fracture fixation.
- Stainless steel is a common material for orthopedic implants.
Observation:
- Four patients developed extensive callus or osteomyelitis after surgery.
- The patients had closed femoral shaft fractures treated with Kuntscher nailing and cerclage wiring.
- Both implants were made of stainless steel but with different elemental compositions.
Findings:
- Galvanic reactions were observed between the Kuntscher nail and cerclage wire.
- Potential differences of up to 4.5 mV were measured in wound drainage fluid.
- These potential differences correlate with previously reported associations with extensive callus and stainless steel anode corrosion-related infections.
Implications:
- The study suggests a potential link between galvanic corrosion of dissimilar stainless steel implants and adverse patient outcomes.
- Further research is needed to investigate the long-term effects and clinical significance of these galvanic reactions.
- Consideration of implant material compatibility may be important in preventing complications like osteomyelitis and excessive callus formation.
