全髋关节翻修术后因术中陶瓷骨折导致铬钴中毒并伴有严重全身并发症
Chromium-Cobalt Intoxication with Intense Systemic Complications following Total Hip Revision after Per-Operative Ceramic Fracture.
作者信息
Lecoanet Paul, Blangis Mathias, Garcia Matthieu, Legallois Yohan, Fabre Thierry
机构信息
CHU de Bordeaux, Place Amélie Raba-Léon, 33000 Bordeaux, France.
出版信息
Case Rep Orthop. 2019 Jan 27;2019:4209796. doi: 10.1155/2019/4209796. eCollection 2019.
INTRODUCTION
Heavy metal intoxication after arthroplasty is extremely rare but could be lethal. We report the case of a 69-year-old woman, who presented intense systemic symptoms of chromium-cobalt intoxication after revision of per-operative fractured ceramic components with metal-on-polyethylene. Systemic toxicity occurred a year after surgery and expressed brutally with mostly central neurological symptoms. Chelation associated with revision surgery allowed rapid regression of all symptoms.
CONCLUSION
Revision of fractured ceramic, even per-operatively, should not be done with metal-on-polyethylene components, in order to avoid potentially lethal metal intoxication.
引言
关节置换术后重金属中毒极为罕见，但可能致命。我们报告了一例69岁女性病例，该患者在使用金属对聚乙烯的人工关节翻修术中，因术中陶瓷部件骨折而出现严重的铬钴中毒全身症状。全身中毒发生在手术后一年，并以主要的中枢神经症状突然表现出来。螯合疗法联合翻修手术使所有症状迅速缓解。
结论
为避免潜在的致命金属中毒，即使是在术中，也不应使用金属对聚乙烯部件对骨折陶瓷进行翻修。
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