Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2013 Apr;26(2):147-150. Korean.
    Published online Apr 22, 2013.
    https://doi.org/10.12671/jkfs.2013.26.2.147
    Copyright © 2013 The Korean Fracture Society
    Case Report

    Extensive Metallosis Caused by Plate and Screw Construct for Distal Fibular Fracture - A Case Report -

    Ki-Tae Park, M.D. and Kwang-Bok Lee, M.D.
      • Department of Orthopedic Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Gwangju, Korea.
    • Address reprint requests to: Kwang-Bok Lee, M.D. Department of Orthopedic Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 561-712, Korea. Tel: 82-63-250-2586, Fax: 82-63-271-6538, Email: osdr2815@naver.com
    Received June 04, 2012; Revised September 01, 2012; Accepted December 31, 2012.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Metallosis has been reported in the setting of weight-bearing joint arthroplasties, like the hip and knee joints. However, the prevalence of metallosis in non-articular portions is very uncommon. We report a rare case of a patient who had metallosis secondary by fibular nonunion after fixation with plate and screw. In addition, we discuss the clinical and the operative findings, as well as the outcome of this uncommon complication.

    Keywords
    Fibular fracture; Metallosis; Nonunion; Plate and screw construct

    Figures

    Fig. 1
    Preoperative left tibia anteroposterior (A) lateral (B) images show the nonunion, osteolytic bone defect and hardware the failure on the fibular fracture site.

    Fig. 2
    Operative photos (A-D) show the broken plate and extensive gray-black colored tissue around the plate, and clean bony tissue after the removal of the plate and gray-black colored tissue.

    Fig. 3
    Postoperative left tibia anteroposterior (A) lateral (B) images show the internal fixation with rush pin and autogenous bone graft for bone defect and nonunion site.

    Fig. 4
    Histologic photos demonstrate the fibrous stroma admixed with bone and necrotic debris (white arrow) (A: H&E, ×40) and inflammatory cells (white arrow) and foreign-body giant cell (black arrow) (nuclei arranged haphazardly) in the fibrous stroma (B: H&E, ×200).

    Fig. 5
    Final follow-up left tibia anteroposterior (A) lateral (B) images show bony consolidation of fibular nonunion and bony defect area.

    References

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    MeSH Terms
    Arthroplasty
    Hip
    Humans
    Joints
    Knee Joint
    Prevalence
    Weight-Bearing
    Metrics
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