Complications after metal plate stabilization of femoral fracture in a female patient with contact hypersensitivity to chromium, nickel and cobalt

According to some authors, contact allergy to metals may account for 50% of orthopedic failures. In this report, we describe a 40-years old patient who had suffered from contact eczema caused by metal hypersensitivity since her adolescence. In her 28^th year of life, the patient had a skiing accident that resulted in subtrochanterical femoral fracture with multiple bone fragmentation. As a therapy, osteosynthesis was performed with metal plates and nails. After the surgery, contact dermatitis of the patient became more severe. Due to the lack of progress in the orthopedic therapy, the metal objects finally were removed. Patch tests have confirmed allergy to cobalt, nickel and chromium, which all were components of the implanted orthopedic alloys. We conclude that contact allergy to metals was the reason for the described orthopedic complications. This points on the need of preoperative screening of orthopedic patients for contact allergy to metals.

Key words: femoral fracture, osteosythesis, contact allergy, chromium, nickel, cobalt.

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In vitro patch testing