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一例股骨远端钢板固定失败致金属沉着病的病例报告

A Case Report of Metallosis With a Failed Distal Femur Plate.

作者信息

Kumar Akshay, Zaidi Syed Muhammad Hussain, Sahito Badaruddin, Kumar Dileep, Ali Maratib

机构信息

Internal Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK.

Orthopaedic Surgery, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK.

出版信息

Cureus. 2020 Sep 10;12(9):e10361. doi: 10.7759/cureus.10361.

Abstract

Metallosis is a very rare condition that poses a diagnostic challenge. Its precise incidence is not known and the condition should be suspected in patients who present with the clinical signs and symptoms discussed below. In particular, physicians and surgeons should pay special attention to whether metal prosthesis has been used for fracture repair or joint function. Here we report the case of a 40-year-old male who presented at an orthopedic surgery outpatient department in a tertiary care hospital with pain in the right distal thigh that had been ongoing for three months and swelling that had been ongoing for two months. According to the patient, he had received an operation for a right-sided distal femur fracture that was fixed with plate at a different hospital one year prior. Despite receiving all the appropriate physical exams and labs, and getting a radiologic workup, the diagnosis was unclear, and ultimately surgical exploration was conducted, which led to the diagnosis of metallosis. Although metallosis is a well-known complication, due to its rarity, physicians and surgeons often forget to keep metallosis as a differential that leads to diagnostic difficulties.

摘要

金属沉着症是一种非常罕见的病症,对诊断构成挑战。其确切发病率尚不清楚,对于出现以下讨论的临床体征和症状的患者应怀疑患有此病。特别是,内科医生和外科医生应特别关注是否使用了金属假体进行骨折修复或关节功能置换。在此,我们报告一例40岁男性病例,该患者因右大腿远端疼痛持续三个月、肿胀持续两个月,前往一家三级护理医院的骨科门诊就诊。据患者称,他一年前在另一家医院接受了右侧股骨远端骨折手术,并用钢板进行了固定。尽管进行了所有适当的体格检查和实验室检查,并进行了影像学检查,但诊断仍不明确,最终进行了手术探查,从而确诊为金属沉着症。尽管金属沉着症是一种已知的并发症,但由于其罕见性,内科医生和外科医生常常忘记将其作为鉴别诊断因素,从而导致诊断困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/212e/7549848/66f17e21ef2d/cureus-0012-00000010361-i01.jpg

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