Thermal Pain

Thermal pain is caused by the conduction of external cold temperatures to the bone through a bone plate with minimal soft tissue coverage. Thermal pain or cold conduction is an anecdotally reported complication of open reduction and internal fixation with bone plates. Implant removal usually alleviates pain and lameness if the underlying bone has healed sufficiently. Few articles report temperature sensitivity in human patients after internal fixation of fractures with bone plates. Another report describes two patients with traumatic defects of the skull repaired with a titanium mesh. Both developed thermal sensitivity that improved after hair grew and covered the surgery site. In a recent review of plate removal after facial fractures in Finland, plates were removed in only 20% of patients. The most common subjective reason for removal was cold sensitivity, thereby supporting the concept that cold climate may influence the need for plate removal.