Measuria H D, McBride T J, Talwalkar S C
Wrightington Upper Limb Unit, Wrightington Wigan and Leigh NHS Foundation Trust, Appley Bridge, WN6 9EP, UK.
Hand Surg. 2013;18(3):429-30. doi: 10.1142/S0218810413720313.
Metallosis is a well-documented phenomenon in hip and knee arthroplasty from metal on metal bearing joint replacements. However, few cases of metallosis of metacarpophalangeal joint replacements have been reported. We present the case of a 49-year-old lady with rheumatoid arthritis who had previously undergone MCP joint replacements over 20 years ago. The decision was taken to revise her middle MCP joint after she developed pain and ulnar drift. At revision, the joint exhibited severe metallosis presumably arising from the grommet component of the replacement. This required considerable debridement and removal of the components and revision to a new upsized implant without grommets. It is of note that there were no external signs of metallosis with full flexion of the finger and a good roll up.
金属沉着病是金属对金属承重关节置换导致的髋关节和膝关节置换术中一种有充分文献记载的现象。然而，掌指关节置换术后发生金属沉着病的病例报道较少。我们报告一例49岁类风湿关节炎女性患者，她在20多年前曾接受过掌指关节置换。在她出现疼痛和尺侧偏斜后，决定对其中指掌指关节进行翻修。翻修时，关节表现出严重的金属沉着病，推测是由置换物的索环部件引起的。这需要进行大量清创、取出部件，并翻修为无索环的新型加大号植入物。值得注意的是，手指完全屈曲且活动良好时没有金属沉着病的外部迹象。
