Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel Plate

Metal hypersensitivity is a rare complication for implants especially with neuropathy involvement. There was not any previous report suggesting metal hypersensitivity manifested in the form of neuropathy or tendinopathy from metal plate implantation. Here, we present a case of a 42-year-old female w...

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Main Authors: Sunyarn Niempoog, Seksan Kukreja
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2020/9789021
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author Sunyarn Niempoog
Seksan Kukreja
author_facet Sunyarn Niempoog
Seksan Kukreja
author_sort Sunyarn Niempoog
collection DOAJ
description Metal hypersensitivity is a rare complication for implants especially with neuropathy involvement. There was not any previous report suggesting metal hypersensitivity manifested in the form of neuropathy or tendinopathy from metal plate implantation. Here, we present a case of a 42-year-old female with chronic ulnar wrist pain and unremarkable physical and radiological findings. Ulna shortening osteotomy with small stainless steel-made DCP and screw fixation was done. On the third day postoperative, the patient developed pain, swelling, ulnar neuropathy, and flexor tendon contracture. Severe adhesion was found around the implant and the ulnar nerve. Minimal skin patch testing reaction and pathological study suggest a cell-mediated delayed type IV hypersensitivity reaction. A titanium-made LCP was later implanted in place of the stainless steel-made DCP. The patient’s clinical status significantly improved after the operation. Metal hypersensitivity in this patient was unprecedented and unique. The severity of the reaction and its location close to the ulnar nerve may predispose to the intensity of the reaction.
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spelling doaj-art-dd47cea500b840e7b9aa07d9e400a3642025-02-03T00:59:42ZengWileyCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/97890219789021Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel PlateSunyarn Niempoog0Seksan Kukreja1Orthopedics Department, Faculty of Medicine, Thammasat University, ThailandOrthopedics Department, Faculty of Medicine, Thammasat University, ThailandMetal hypersensitivity is a rare complication for implants especially with neuropathy involvement. There was not any previous report suggesting metal hypersensitivity manifested in the form of neuropathy or tendinopathy from metal plate implantation. Here, we present a case of a 42-year-old female with chronic ulnar wrist pain and unremarkable physical and radiological findings. Ulna shortening osteotomy with small stainless steel-made DCP and screw fixation was done. On the third day postoperative, the patient developed pain, swelling, ulnar neuropathy, and flexor tendon contracture. Severe adhesion was found around the implant and the ulnar nerve. Minimal skin patch testing reaction and pathological study suggest a cell-mediated delayed type IV hypersensitivity reaction. A titanium-made LCP was later implanted in place of the stainless steel-made DCP. The patient’s clinical status significantly improved after the operation. Metal hypersensitivity in this patient was unprecedented and unique. The severity of the reaction and its location close to the ulnar nerve may predispose to the intensity of the reaction.http://dx.doi.org/10.1155/2020/9789021
spellingShingle Sunyarn Niempoog
Seksan Kukreja
Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel Plate
Case Reports in Orthopedics
title Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel Plate
title_full Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel Plate
title_fullStr Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel Plate
title_full_unstemmed Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel Plate
title_short Neuropathy Caused by Metal Hypersensitivity after Placement of Stainless Steel Plate
title_sort neuropathy caused by metal hypersensitivity after placement of stainless steel plate
url http://dx.doi.org/10.1155/2020/9789021
work_keys_str_mv AT sunyarnniempoog neuropathycausedbymetalhypersensitivityafterplacementofstainlesssteelplate
AT seksankukreja neuropathycausedbymetalhypersensitivityafterplacementofstainlesssteelplate