ABSTRACT
Metal implant devices have a long, reliable clinical history,
are relatively cheap, and easy to produce and shape. These
implants used in hand and wrist surgery also have their
disadvantages. Large differences between Young’s moduli of
the implants and bone often lead to stress shielding resulting
in osteopenia which may result in pathologic fractures (1).
In addition, elevated stress concentration at the junction of the
implants and the host bone may result in periprosthetic
fractures. Implantation of metallic devices often requires
significant soft tissue stripping which reduces the local
blood supply about the implant. This effect is constant
during the entire time the implant is in place. Metallic
devices also have the potential for corrosion and wear and
debris formation with subsequent metallosis (2). Prominent or
protruding metallic hardware may interfere with surrounding
tissues that disturb joint movement, tendon gliding, or even
cause tendon ruptures resulting in pain and loss of function.
This effect is particularly important around the hand and
wrist. Often times these implants need to be removed. Stern
et al. (3) and Berman et al. (2) have reported a need for plate
removal in 25% of cases of metacarpal and proximal
phalangeal fractures.
