The overall biocompatibility characteristics of metallic implants are important considerations in orthopedic surgery. A review of the literature shows very few reports of neoplasms in association with metallic implants. This case report demonstrates osteogenic sarcoma at the site of a Smith-Petersen nail that had been implanted for nine years in a 65-year-old woman for fixation of a femoral neck fracture. Gross examination revealed debris at the tumor site, with a concentration of 14 ppm of nickel within the tumor tissue. Experimental investigations support the possibility of neoplastic induction by heavy metals, particularly cobalt, cadmium, and nickel. Circumstantial evidence shows osteogenic sarcoma that developed at the site of this device, possibly in response to metal or factors at the site of metal.
* From the Department of Orthopaedic Surgery, Louisiana State University Medical Center, Shreveport, Louisiana.
** Montgomery, Alabama.
† From the Department of Biomaterials, University of Alabama at Birmingham Medical Center, Birmingham, Alabama.
‡ From the Department of Orthopaedic Surgery, University of Alabama at Birmingham Medical Center, Birmingham, Alabama.
Reprint requests to William K. Dunham, M.D., Orthopaedic Surgeons East, Suite 101, 52 Medical Park East Drive, Birmingham, AL 35235.
Received: September 21, 1987.