D. G. Dennison. Distal Radius Fractures and Titanium Volar Plates: Should We Take the Plates Out?//J. Hand Surg. - Vol.35A. - January 2010. - P.141-143. - "From the information currently available, it seems that the likelihood of a significant elevation of serum titanium after volar plating of fractures of the distal radius should be low. Hand surgeons might think that an intramedullary nail in the setting of a united fracture
(without any evidence of implant-implant or bone-implant wear) is a reasonable clinical situation in which to evaluate the serum titanium level. Taking into account the larger implant size and intramedullary position of the nail, the intramedullary nail studies may reflect a worst-case scenario of a large surface area being exposed to the patient. With the level of serum titanium remaining within reference ranges, it seems reasonable
to conclude that the titanium nail can be retained with an acceptable level of risk and therefore that a retained titanium volar distal radius plate would have a similar or less risk".
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