Serum nickel level in patients with facial bone fractures treated with 0.5mm stainless steel wire

Abstract

Background: Various treatment modalities have been employed in the management of facial fractures, including transosseous wiring using stainless steel wire. Transosseous wires used in fixing maxillofacial fractures gradually undergo disintegration leading to the release of nickel into the blood. Aim : To investigate the serum level of nickel in patients treated with stainless steel transosseous wires. Methods: This was a prospective study carried out over a period of nine months in the Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Nigeria. The study involved 101 subjects, 77 males and 24 females (male: female ratio of 3:1) who had maxillofacial fractures. The age of the subjects ranged between 10 and 70 years. Blood samples were collected at four different periods from each patient before the
insertion of 0.5mm transosseous wires, at one, three and six months. Results: The results showed differences in the amounts of nickel released from transosseous wire during different periods of treatment. There was increase in nickel level in the first month (0.46 ± 0.09μg/l), reaching its highest levels in the sixth month (0.68 ± 0.06 μg/l). Conclusion: Transosseous wiring using 0.5mm stainless steel wire release measurable amount of nickel into patients’ serum. The serum level of nickel in the patients in this study was comparable to the values found in healthy individuals, showing that the patients did not attain toxic serum levels for nickel within the period of study. It is however recommended that transosseous wires should not be removed within six months.
Key Words : Serum nickel; facial bone; fracture; stainless steel wire; transosseous; maxillofacial surgery.