O2495 DELAYED ONSET PAIN AROUND FIXATION IMPLANTS

Abstract

Aim: Fixation implants are usually well tolerated by the patients for prolonged periods of time. However, it is not unusual for some patients to develop persistent pain with acute onset that is often combined with paresthesias. The purpose of this study was to verify if the acute onset of pain that is not combined with clinical or laboratory signs of infection could be attributed to an underlying bacterial colonization of implants. Methods: Sixty-four patients (38 male and 26 female) with mean age of 36 years (range, 10 to 73 years) were included in this study. Patients presented with acute onset of pain and/or paresthesias several years after the implantation of stainless-steel þxation materials (plate-screws: 52 and intramedullary nails: 12), in the upper (13) or lower extremity (51). All patients of the present series had negative clinical and laboratory signs of infection. All patients of the present series had their þxation materials removed in our department. The materials subsequently underwent microbiologic and corrosion evaluation. Results: Patients experienced immediate relief after removal of þxation materials. Cultures were positive in 18% of cases and Staph aureus and epidermidis were most frequently encountered. Pseudomonas and enterococcus were also cultured. Conclusions: The percentage of positive cultures (18%) in the patients of our series indicates that symptoms may be due to the bacterial colonization of implants, despite the absence of sings of infection. Although the administration of antibiotics remains controversial, removal of the implants is indicated in cases with acute delayed onset of pain at the site of the implanted þxation materials.