Composition and toxicity of shrapnel in mine-explosive and fragmentation craniocerebral wounds compared to titanium implants: a pilot study

Orlov VP, Nashchekina YuA, Nikonov PO, et al. Composition and toxicity of shrapnel in mine-explosive and fragmentation craniocerebral wounds compared to titanium implants: a pilot study. Burdenko's Journal of Neurosurgery. 2026;90(1):6‑13. (In Russ., In Engl.)
https://doi.org/10.17116/neiro2026900116

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

To evaluate elemental composition and cytotoxicity of metal fragments of wounding projectiles based on modern alloys from mine blast and shrapnel craniocerebral wounds in comparison with titanium plates (control) in relation to human cell line T98G (human, glioblastoma, epithelial-like environment EMEM).

MATERIAL AND METHODS

We studied 12 wounding projectiles removed from the brain. Three ferromagnetic samples were selected to determine composition and cytotoxicity. Composition of fragments was studied using spectral analysis. Surface of samples and their elemental composition were examined using electron microscope (SEM) JSM-7001F (JEOL, Japan) equipped with X-ray spectral microanalysis attachment INCA x-sight (Oxford Instruments, England). Cytotoxicity of medium with wounding projectiles was determined in comparison with control medium using methyl tetrazolium test. Human cell line T98G (human, glioblastoma) (Institute of Cytology, St. Petersburg) was used to study cytotoxicity of fragments and titanium plates (control). Cell morphology was assessed using optical light microscopy.

RESULTS

According to elemental analysis, all fragments were represented by alloys of various metals and other chemical elements. Methyl-tetrazolium test revealed high cytotoxicity of all fragments. Titanium VT6 plates were biocompatible with cultured cells.

CONCLUSION

All fragments of modern projectiles release toxic metal oxides in nutrient medium significantly reducing viability of cells regardless of elemental composition of fragments. VT6 titanium plates are biocompatible with cultured cells and can be used as implants during surgical interventions.

Keywords:

gunshot traumatic brain wounds

fragment toxicity

methyl tetrazolium test

elemental analysis of fragments

electron microscopy

titanium VT6 implant

Authors:

Orlov V.P.

Kirov Military Medical Academy

ORCID: 0000-0002-5009-7117

Nashchekina Yu.A.

Institute of Cytology

ORCID: 0000-0002-4371-7445

Nikonov P.O.

Institute of Cytology

ORCID: 0000-0002-0821-8042

Nashchekin A.V.

Ioffe Physical-Technical Institute

ORCID: 0000-0002-2542-7364

Mirzametov S.D.

Kirov Military Medical Academy

ORCID: 0000-0002-1890-7546

Martynov B.V.

Kirov Military Medical Academy

ORCID: 0000-0002-8459-2466

Ivankova E.M.

Kirov Military Medical Academy

ORCID: 0000-0002-4823-0695

Vasileva N.K.

Kirov Military Medical Academy

ORCID: 0000-0003-0106-2441

Svistov D.V.

Kirov Military Medical Academy

SPIN RSCI: 3184-5590
Scopus AuthorID: 6602724544
ORCID: 0000-0002-3922-9887

Received:

21.03.2025

Accepted:

26.11.2025

Close metadata

References:

Aaronson DM, Awad AJ, Hedayat HS. Lead toxicity due to retained intracranial bullet fragments: illustrative case. J Neurosurg Case Lessons. 2022; 4(13):CASE21453. https://doi.org/10.3171/CASE21453
Sergeev AA, Shiryaev VV, Dvornikov MG, Tetera VA. Lead poisoning of wild animals and prospects for the use of non-toxic hunting ammunition In Russia. Dal’nevostochnyj agrarnyj vestnik. 2020;1(53):71-83. (In Russ.). https://doi.org/10.24411/1999-6837-2020-11010
Apte A, Bradford K, Dente C, Smith RN. Lead toxicity from retained bullet fragments: A systematic review and meta-analysis. Journal of Trauma and Acute Care Surgery. 2019;87(3):707-716. https://doi.org/10.1097/TA.0000000000002287
Kazim SF, Shamim MS, Tahir MZ, Enam SA, Waheed S. Management of penetrating brain injury. Journal of Emergencies, Trauma, and Shock. 2011;4(3):395-402. https://doi.org/10.4103/0974-2700.83871
Chaudhri KA, Choudhury AR, al Moutaery KR, Cybulski GR. Penetrating craniocerebral shrapnel injuries during «Operation Desert Storm»: early results of a conservative surgical treatment. Acta Neurochirurgica. 1994;126(2-4):120-123. https://doi.org/10.1007/BF01476420
Surgical management of penetrating brain injury. The Journal of Trauma: Injury, Infection, and Critical Care. 2001;51(2):16-25. https://doi.org/10.1097/00005373-200108001-00006
Esposito DP, Walker JB. Contemporary Management of Penetrating Brain Injury. Neurosurgery Quarterly. 2009;19(4):249-254. https://doi.org/10.1097/WNQ.0b013e3181bd1d53
Hoffman JF, Vergara VB, Kalinich JF. Brain region- and metal-specific effects of embedded metals in a shrapnel wound model in the rat. Neurotoxicology. 2021;83:116-128. https://doi.org/10.1016/j.neuro.2021.01.001
Kalinich JF, Emond CA, Dalton TK, Mog SR, Coleman GD, Kordell JE, Miller AC, McClain DE. Embedded weapons-grade tungsten alloy shrapnel rapidly induces metastatic high-grade rhabdomyosarcomas in F344 rats. Environmental Health Perspectives. 2005;113(6):729-734. https://doi.org/10.1289/ehp.7791
Schuster BE, Roszell LE, Murr LE, Ramirez DA, Demaree JD, Klotz BR, Rosencrance AB, Dennis WE, Bao W, Perkins EJ, Dillman JF, Bannon DI. In vivo corrosion, tumor outcome, and microarray gene expression for two types of muscle-implanted tungsten alloys. Toxicology and Applied Pharmacology. 2012;265(1):128-138. https://doi.org/10.1016/j.taap.2012.08.025
Legrand M, Elie C, Stefani J, N Florès, Culeux C, Delissen O, Ibanez C, Lestaevel P, Eriksson P, Dinocourt C. Cell proliferation and cell death are disturbed during prenatal and postnatal brain development after uranium exposure. Neurotoxicology. 2016;52:34-45. https://doi.org/10.1016/j.neuro.2015.10.007
Dinocourt C, Culeux C, Legrand M, Elie C, Lestaevel P. Chronic Exposure to Uranium from Gestation: Effects on Behavior and Neurogenesis in Adulthood. International Journal of Environmental Research and Public Health. 2017;14(5):536. https://doi.org/10.3390/ijerph14050536
Barres BA, Freeman MR, Stevens B. Glia. New York: Cold Spring Harbor Laboratory Press; 2015.
Fuster E, Candela H, Estévez J, Arias AJ, Vilanova E, Sogorb MA. Effects of silver nanoparticles on T98G human glioblastoma cells. Toxicology and Applied Pharmacology. 2020;404:115178. https://doi.org/10.1016/j.taap.2020.115178
Fuster E, Candela H, Estévez J, Vilanova E, Sogorb MA. Titanium Dioxide, but Not Zinc Oxide, Nanoparticles Cause Severe Transcriptomic Alterations in T98G Human Glioblastoma Cells. International Journal of Molecular Sciences. 2021;22(4):2084. https://doi.org/10.3390/ijms22042084
Klotz K, Weistenhöfer W, Neff F, Hartwig A, van Thriel C, Drexler H. The Health Effects of Aluminum Exposure. Deutsches Arzteblatt International. 2017;114(39):653-659. https://doi.org/10.3238/arztebl.2017.0653
Andrade VM, Aschner M, Marreilha Dos Santos AP. Neurotoxicity of Metal Mixtures. Advances in Neurobiology. 2017;18:227-265. https://doi.org/10.1007/978-3-319-60189-2_12
Murumulla L, Bandaru LJM, Challa S. Heavy Metal Mediated Progressive Degeneration and Its Noxious Effects on Brain Microenvironment. Biological Trace Element Research. 2024;202(4):1411-1427. https://doi.org/10.1007/s12011-023-03778-x
Tanaka KI, Kasai M, Shimoda M, Shimizu A, Kubota M, Kawahara M. Nickel Enhances Zinc-Induced Neuronal Cell Death by Priming the Endoplasmic Reticulum Stress Response. Oxidative Medicine and Cellular Longevity. 2019;2019:9693726. https://doi.org/10.1155/2019/9693726