Serum titanium levels in individuals undergoing intramedullary femoral nailing with a titanium implant

Sean McGarry, Steven J. Morgan, Ruth M. Grosskreuz, Allison E. Williams, Wade R. Smith

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


BACKGROUND: Many patients request nail extraction or question the long-term effects of hardware retention. Systemic titanium degradation products may influence the timing of such decisions. The orthopedic literature provides no data regarding systemic titanium in patients undergoing intramedullary nail fixation with titanium implants. The purpose of this study was to determine the systemic level of serum titanium in patients who had undergone femoral nailing. METHODS: Patients who underwent antegrade locked femoral nailing utilizing a reamed technique with a titanium implant were eligible to participate. Eight patients were recruited for each of four time points: 6 weeks, 3 months, 6 months, and 1 year. Blood samples were collected from each subject. Serum titanium levels were analyzed through inductively coupled plasma/mass spectrometry (ELAN DRC II, Perkin Elmer, SCIEX, Inc, Shelton, CT). Test sensitivity was 0.2 μg/L. Normal serum titanium levels are <150 μg/L. RESULTS: Thirty-two patients were enrolled. The study group included 10 women and 22 men with average age of 32 (range 19-63) years. The most common fracture pattern was 32-A3 (n = 12), followed by 32-B2 (n = 9). No patients showed an elevated serum titanium level. Mean titanium levels were 49.38, 58.25, 49.38, and 50.63 μg/L at 6 weeks, 3 months, 6 months, and 12 months cohorts, respectively. No statistically significant differences were found (p = 0.207). CONCLUSIONS: Standard intramedullary nail fixation of femur fractures did not result in elevated levels of serum titanium in the first year after surgery. Differences in serum titanium did not differ significantly across time since implantation.

Original languageEnglish (US)
Pages (from-to)430-433
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number2
StatePublished - Feb 2008
Externally publishedYes


  • Femur fracture
  • Intramedullary femoral nailing
  • Systemic titanium levels

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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