Child Orthopedics

Frequently Asked Questions

Our 11-year-old daughter fell in soccer practice with half the team on top of her. She broke both bones in her forearm. They had to put a couple of screws in the bones to hold them together while she heals. I'm worried because she tends to be allergic to everything. Could she have an allergic reaction to the metal screws?

Metal plates, pins, and screws referred to as instrumentation or orthopedic implants are sometimes used to stabilize fractures or hold a fusion site together until healing can take place. Although uncommon, complications such as infection, allergic response, or even malignancy (tumor) around the implants can occur. There's no real evidence that these complications were caused by the implant. The fact that the implant is present makes it a likely suspect when anything out of the ordinary occurs. There's no evidence that someone who has allergic responses in general is more likely to develop an allergy to an implant. Skin sensitivity to nickel and chromium occurs in a small percentage of the general population. A skin reaction called dermatitis can develop. Whether or not these same individuals would react to an internal implant is unknown. Pain would be the most likely symptom to develop. The implant might loosen as a result of the body's defense reaction against the device. Again, pain would be the first sign of a problem. Let the surgeon know of your concerns. He or she will monitor the child more closely and let you know what to watch for as a suspicious sign of anything that requires further follow-up.

Ellen M. Raney, MD, et al. Evidence-Based Analysis of Removal of Orthopaedic Implants in the Pediatric Population. In Journal of Pediatric Orthopaedics. October/November 2008. Vol. 28. No. 7. Pp. 701-704.

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