Ki-Tae Park; Kwang-Bok Lee

doi:10.12671/jkfs.2013.26.2.147

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Case Report
Extensive Metallosis Caused by Plate and Screw Construct for Distal Fibular Fracture - A Case Report -: Ki-Tae Park, M.D., Kwang-Bok Lee, M.D.; Journal of the Korean Fracture Society 2013;26(2):147-150.
DOI: https://doi.org/10.12671/jkfs.2013.26.2.147
Published online: April 22, 2013

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, osdr2815@naver.com

• Received: June 4, 2012 • Revised: September 1, 2012 • Accepted: December 31, 2012

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Abstract
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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.
Key words: Fibular fracture, Metallosis, Nonunion, Plate and screw construct

REFERENCES

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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.

Figure & Data

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Plate on Plate Osteosynthesis for the Treatment of Nonhealed Periplate Fractures
Georgios Arealis, Vassilios S. Nikolaou, Andrew Lacon, Neil Ashwood, Mark Hamlet
ISRN Orthopedics.2014; 2014: 1. CrossRef

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

J Korean Fract Soc. 2013;26(2):147-150. Published online April 30, 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.2.147

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

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.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

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