Takatori Ryota, Tokunaga Daisaku, Hojo Tatsuya, Ikoma Kazuya, Nagasawa Koji, Kubo Toshikazu
Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Mod Rheumatol. 2005;15(5):364-6. doi: 10.1007/s10165-005-0413-y.
We report a case of rheumatoid arthritis treated by bilateral flexible hinge toe implant arthroplasty, using grommets only on one side, which resulted in bilateral fractures requiring removal of the implants 6.5 years after the surgery. Both implants were completely fractured at the bottom of the distal stems. Macroscopically, synovitis was present around both fractured stems, although the severity of synovitis and fragmentation of the fractured implant was relatively mild on the right side in which grommets were used. The shape of the body of the fractured implant was relatively preserved on the right side in which grommets were used. There was no damage or fracture of the grommets. The grommet might have acted to prevent pressures and scratches that would cause synovitis and deformity of the body of the implant, but might not completely prevent fractures of implants.
我们报告了一例类风湿性关节炎患者，其接受了双侧柔性铰链趾植入关节成形术，仅在一侧使用索环，术后6.5年导致双侧骨折，需要取出植入物。两个植入物均在远端柄底部完全骨折。宏观上，两个骨折柄周围均存在滑膜炎，尽管在使用索环的右侧，滑膜炎的严重程度和骨折植入物的碎裂程度相对较轻。在使用索环的右侧，骨折植入物主体的形状相对保留。索环没有损坏或骨折。索环可能起到了防止引起滑膜炎和植入物主体变形的压力和刮擦的作用，但可能无法完全防止植入物骨折。
