APSA PaperWhen it is not an infection: metal allergy after the Nuss procedure for repair of pectus excavatum
Section snippets
Materials and methods
This study is a retrospective review of patients who presented with concerns for metal allergy after undergoing minimally invasive repair of pectus excavatum by the pediatric surgery service at Eastern Virginia Medical School, a tertiary referral center. Institutional review board approval was obtained for this study (01-05-EX-0175). All data collection complied with HIPAA regulations. Inclusion criteria were (1) repair of pectus excavatum with the minimally invasive Nuss procedure and (2)
Results
During an 18-year period (1987-2005), 862 patients underwent minimally invasive repair of pectus excavatum. Of these 862 patients, 19 had suspected metal allergy on preoperative screening or postoperative follow-up, resulting in a 2.2% incidence. The average follow-up time was 25 months (range, 1-67 months). Ninety-five percent (18) of patients diagnosed with metal allergy were males (P = .513), with an average age of 14.7 years (range, 9-23 years) (P = .705). Some history of atopy (eczema,
Discussion
The 2.2% incidence of metal allergy seen in our patient population is far less than the 13% traditionally reported in the orthopedic literature [15], [16], [17]. However, those studies investigated metal hip joints, not static metal implants such as the pectus bar implant used for our patients. Ninety-five percent of the patients with allergies in our study population were males. Pectus excavatum affects males predominantly, which is why this might not have reached statistical significance.
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Presented at the 37th Annual Meeting of the American Pediatric Surgical Association, May 20–24, 2006, Hilton Head, SC.