J Korean Fract Soc.  2013 Apr;26(2):147-150. 10.12671/jkfs.2013.26.2.147.

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

• Park KT
• Lee KB

• KMID: 1496170
• DOI: http://doi.org/10.12671/jkfs.2013.26.2.147

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.

Keyword

Fibular fracture; Metallosis; Nonunion; Plate and screw construct

MeSH Terms

Arthroplasty
Hip
Humans
Joints
Knee Joint
Prevalence
Weight-Bearing

Figure

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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.

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  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.

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  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.

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  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).

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  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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