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 orthopaedic 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 subtochanterical 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 orthopaedic therapy, the metal objects finally were removed. Patch tests have confirmed allergy to cobalt, nickel and chromium, which all were components of the implanted orthopaedic alloys. We conclude that contact allergy to metals was the reason for the described orthopaedic complications. This points on the need of preoperative screening of orthopaedic patients for contact allergy to metals.

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

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