Metallurgical Considerations

Abstract

Nicole (1940, 1947) was one of the first to carry out comprehensive scientific research in metals used for internal fixation. He concluded that complete success could only be guaranteed when two conditions were fulfilled: keeping a balance between mechanical and physiological requirements on one hand, and on the other, avoiding any damage caused by the metal during the whole period of bone healing. Favourable biomechanical conditions depend largely on the surgical technique applied to an individual case. Prevention of damage by the metal depends upon the specific material used. It is remarkable that these two factors were appreciated in Nicole’s time, since metallurgical and chemical technology had not produced the same quality of corrosion resistant metals as are available today. Nicole realized that a foreign body implanted according to biomechanical criteria could produce perfect fracture healing in spite of corrosion and toxic effects of the metal, or, as he expressed it “the body is capable of overcoming the ill-effects of metal to a certain extent”. Nicole wrote that “the development of high quality in metal implants is an important field for research but the central problem of internal fixation is to guarantee a balance between physiological and mechanical requirements until the fracture has consolidated”.