Intraosseous bioabsorbable poly-L-lactic acid screw presenting as a late foreign-body reaction: a case report.
A 17-year-old woman complained of a localized painful swelling in her foot 30 months after internal fixation of a closed tarsometatarsal joint fracture with interfragmentary poly-L-lactic acid screws. Aspiration revealed a sterile abscess. Radiographs displayed an osteolytic lesion corresponding to a screw track in the first tarsometarsal joint. Formation of a draining sinus tract required surgical excision of a small granulomatous lesion. Histologic analysis found deposits of birefringent polymeric particles surrounded by a nonspecific foreign-body type reaction. This represents the first reported case of a draining sinus tract secondary to the use of polylactic acid screw fixation.
Mosier-Laclair
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S
Portland Orthopaedic Foot & Ankle Center, ME 04106, USA.
Pike
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H
Pomeroy
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G
D000038:Abscess / Q000209:etiology; D020341:Absorbable Implants / Q000009:adverse effects*; D000293:Adolescent; D001863:Bone Screws / Q000009:adverse effects*; D005260:Female; D018409:Foot Injuries / Q000150:complications / Q000601:surgery; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000628:therapy; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery; D006801:Humans; D019344:Lactic Acid / Q000009:adverse effects*; D011091:Polyesters; D011108:Polymers / Q000009:adverse effects*; D011183:Postoperative Complications; D013640:Tarsal Joints / Q000293:injuries / Q000601:surgery*; D013997:Time Factors
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)