Nickel allergy and osteomyelitis in a patient with metal osteosynthesis of a jaw fracture.
A 27-year-old female, after a fracture of the mandible treated with osteosynthesis and after a difficult extraction, developed osteomyelitis with fistulation and sequestration. Sequestrectomy and extraction of the teeth in the osteomyelitic area did not clear the patient of symptoms. A patch test to nickel turned out to be positive. After removal of the stainless steel cerclage in the mandible, clinical and radiographic changes returned to normal within 2 and 8 weeks, respectively. It is concluded that, whenever acute treatment does not take priority, patch tests comprising nickel, cobalt and chromium should be performed in patients who are candidates for metal osteosynthesis.
D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D008337:Mandibular Fractures / Q000601:surgery*; D009532:Nickel / Q000009:adverse effects*; D010019:Osteomyelitis / Q000209:etiology*; D010328:Patch Tests
D009532:Nickel