J Korean Fract Soc.  2012 Apr;25(2):142-145. 10.12671/jkfs.2012.25.2.142.

Delayed Foreign-body Reaction of Ankle Fracture Treated with a Biodegradable Plate and Screws: A Case Report

• Park CH
• Song DH
• Cho JH

• KMID: 2015458
• DOI: http://doi.org/10.12671/jkfs.2012.25.2.142

Abstract

Biodegradable implants made of co-polymers composed of L-lactide, D-lactide, and trimethylene carbonate were used in the present case. To our knowledge, only one reported tissue reaction has been associated with ankle fracture treated with third-generation implants internationally and none yet domestically. We report a delayed foreign-body reaction of ankle fracture treated with a third-generation biodegradable plate and screws. We suggest that ankle fracture patients treated with biodegradable implants should be advised of this possible complication and should be followed for at least 2 years.

Keyword

Ankle fracture; Biodegradable; Foreign-body reaction

MeSH Terms

Absorbable Implants
Animals
Ankle
Carbon
Dioxanes
Foreign-Body Reaction
Humans
Carbon
Dioxanes

Figure

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  Fig. 1 (A) Preoperative radiograph showing a lateral malleolar fracture. (B) Radiograph made one week after open reduction and internal fixation with biodegradable implants. (C) Biodegradable plate and screws (Inion OTPS™, Inion Oy, Tampere, Finland).

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  Fig. 2 The patient noted a gradually enlarging soft-tissue mass adjacent to the previous surgical scar.

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  Fig. 3 (A) On radiographs, the fracture had healed but osteolytic change had occurred. (B) Magnetic resonance imaging showed a healed lateral malleolar fracture accompanied by an oval mass with an accumulation of fluid in the sinus formation.

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  Fig. 4 (A) Intraoperative clinical photographs showing a collection of fluid accompanied by several fragments of whitish material. (B) Granulomatous tissue and foreign-body fragments.

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  Fig. 5 (A) Photomicrograph showing some variably shaped, hyaline foreign-body material with a rhomboid shape (H&E stain, ×100). (B) Photomicrograph showing fragments surrounded by a foreign-body reaction with mononuclear cells, foamy histiocytes, foreign body-type multinucleated giant cells, and granulation tissue in the stroma (H&E stain, ×400).

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