Hywel Dda University Health Board, Carmarthen, UK
Wye Valley NHS Trust, Hereford, UK.
BMJ Case Rep. 2023 Dec 21;16(12):e257031. doi: 10.1136/bcr-2023-257031.
This case presents a known complication of particulate synovitis granuloma associated with a first metatarsophalangeal joint silastic implant. However, the degree of soft tissue granuloma enlargement is quite unique in size and its proliferative effect-invading the medulla cavity and infiltrating the outer cortex of bone. This case study aims to demonstrate its clinical presentation, imaging investigations, surgical excision and histopathology findings. The learning points emphasised within this manuscript draw attention to the procedure selection for a silastic implant, as well as its proposed mode of action and various potential associated complications. Surgery was based on careful analysis of overall function, prior surgery conducted and patient expectations to achieve a shared decision-making process.
本病例呈现了首例跖趾关节硅橡胶植入物引起的颗粒性滑膜炎肉芽肿的已知并发症。然而，软组织肉芽肿的增大程度在大小上是非常独特的，其增生效应侵入骨髓腔并浸润骨的外皮质。本病例研究旨在展示其临床表现、影像学检查、手术切除和组织病理学发现。本文强调的学习要点提请注意硅橡胶植入物的选择程序，以及其建议的作用模式和各种潜在的相关并发症。手术是基于对整体功能、先前手术和患者期望的仔细分析，以实现共同的决策过程。
