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Characteristics of stainless steel bone plates:
Material composition and properties: The main component of stainless steel bone plates is 316L stainless steel (alloys of iron, chromium, nickel, molybdenum, etc.), which has a relatively high density and weight, as well as high tensile strength and hardness. However, its elastic modulus is significantly higher than that of the bone cortex, which can easily lead to the “stress shielding” effect, causing the bone to atrophy due to insufficient force.
Corrosion resistance: Generally, after long-term implantation, metal ions (such as nickel) may be released due to corrosion, causing allergies or inflammation.
Biocompatibility: Nickel may cause allergic reactions. After long-term implantation, it may lead to inflammation of surrounding tissues or bone resorption due to corrosion, and it may also interfere with MRI imaging and produce artifacts.
Mechanical properties: Low cost, high strength, suitable for short-term fixed or budget-limited situations. However, the high elastic modulus can easily lead to stress occlusion, requiring a high removal rate through secondary surgery. Its relatively heavy weight may affect patient comfort.
Precautions for the use of stainless steel bone plates
Material selection and combination: When using metal internal fixation materials, it is essential to note that if more than one piece of metal internal fixation material is used in the body, their compositions must be the same. Otherwise, electrolytic corrosion may occur due to potential differences, which can easily cause the internal fixation to break, or the weaker one may break due to different mechanical strengths.
Material surface and structural protection: The inner fixing material should have a good smoothness. If the surface is rough or damaged, it can form a micro-battery and cause electrolytic corrosion. In addition, the internal fixation material should not be bent or deformed; otherwise, it will damage the internal structure, reduce the strength of the bone plate, or cause stress cells, leading to electrolytic corrosion within the metal. Therefore, the surgeon must be aware of the properties of the raw materials of the internal fixator. Used steel plates, screws, etc. cannot be reused. During the operation, the internal fixator should be protected to avoid damaging its surface finish and internal structure, etc.
Indications control: The indications for internal fixation during surgery should be strictly grasped. For instance, when manual reduction and external fixation of fractures fail to meet the functional reduction standards and thus affect limb function; Those with displaced intra-articular fractures whose manual reduction is difficult to achieve satisfactory reduction, which may affect joint function in the future and are prone to traumatic arthritis; Fractures with severe displacement and epiphyseal separation, if not correctly reduced and firmly fixed, are prone to nonunion, malunion and epiphyseal developmental arrest. Severe displacement avulsion fractures, fractures that are difficult to reduce and maintain reduction by closing methods, such as fractures at the greater tubercle of the humerus, etc. Fractures with embedded soft tissues such as muscles, tendons, periosteum, nerves or blood vessels, and failure of manual reduction; Those with functional disorders caused by nonunion of bones or malunion of fractures; When performing limb (finger) replantation surgery, the fracture needs to be fixed first to facilitate the anastomosis of blood vessels and nerves. When bone grafting is required for delayed fracture healing, internal fixation should be performed simultaneously. For multiple fractures and multiple fractures in the same limb, internal fixation can be adopted. This not only eliminates the mutual interference of various injuries in treatment but also facilitates nursing, prevention of serious complications and early patient activities.