There are incidences of long bone fracture non union due to metallosis and implant failure.
How to accurately diagnose this pre operatively and what would be the best way to manage such non unions?
Dear Kunal Aneja, comment, please, the term " non union" in your question when you take in a mind the rejection of implant caused by metallosis.
Dear Mr Shil'ko
What it means is that due to rejection of implant by the host, there is implant failure before the fracture had got the opportunity to be immobilised for adequate duration.
Hence, patient presents with non union of the fracture for which the implant was used in the first instance, along with screws backout and implant failure.
Preoperative diagnosis for the risk of metallosis is difficult and I do not know of any method as of now.
Metal sensitivity is one aspect of it that may be tested for nickel etc..
In advance cases, complications appear and may at times present with sift tissue collection or mass ( more so in arthroplasty like metal on metal -"pseudotumor ") .
Intra-Operative suspicion is possible as altered discoloration of adjacent tissues among other things..
Management is in line with managing any nonunion or 8mplant failure with preferably titanium or PEEK implant used.