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

Ki-Tae Park; Kwang-Bok Lee

doi:10.12671/jkfs.2013.26.2.147

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

Case Report

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2013; 26(2): 147-150.

Published online: 22 April 2013

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

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.

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 4 June 2012 Revised 1 September 2012 Accepted 31 December 2012

(open-access):

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 and Tables

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.

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