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Unusual implant-related soft tissue reaction presenting as a swollen leg: a case report

机译:腿部肿胀引起与种植体相关的异常软组织反应:1例病例报告

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Introduction There are several causes of peri-implant edema, pain, and swelling around implants after orthopedic fixation device application for fracture repair. The most common and well-known reason is infection, however, granulomas associated with foreign body reactions are rarely seen. In this report we present a case of a granulomatous reaction mimicking a hydatid cyst and sarcoma. We emphasize the importance of differential diagnosis in triggering appropriate management of the patient. Our case was unusual; to the best of our knowledge no similar clinical or pathological findings have been reported in current literature. Case presentation A 56-year-old Turkish man who had been treated for a right femoral fracture via a plate fixation 10 years prior underwent an operation to treat pain and swelling around the plate. A hydatid cyst-like mass was observed during surgery, but subsequent examination revealed that no hydatid cyst was present; both malignancy and infection were also absent. Conclusions Although infection is generally the first possibility that should be considered in a patient complaining of pain and swelling in the vicinity of an implant, malignancies, hydatid cysts, and (finally) foreign body reactions should also be kept in mind as differential diagnoses. A soft-tissue reaction around a previously implanted plate should be managed carefully. Pre-operative radiological assessment, and biopsy to allow pathological and microbiological examination, should be considered in all suspected cases.
机译:简介在使用骨科固定装置进行骨折修复后,植入物周围水肿,疼痛和植入物周围肿胀的原因多种多样。最常见和众所周知的原因是感染,但是很少见到与异物反应有关的肉芽肿。在本报告中,我们提出了一个肉芽肿反应的案例,该症状类似于包虫囊肿和肉瘤。我们强调鉴别诊断在触发患者适当治疗中的重要性。我们的案子很不寻常。据我们所知,当前文献中未报道类似的临床或病理发现。病例介绍一名56岁的土耳其男子,在10年之前通过钢板固定术治疗了右股骨骨折,接受了手术以治疗钢板周围的疼痛和肿胀。在手术过程中观察到了包虫样囊肿,但是随后的检查显示没有包虫囊肿。也没有恶性肿瘤和感染。结论尽管通常是抱怨植入物附近疼痛和肿胀的患者首先应考虑感染,但作为鉴别诊断,也应牢记恶性肿瘤,包虫囊肿和(最终)异物反应。应当仔细处理先前植入的钢板周围的软组织反应。所有可疑病例均应考虑术前放射学评估和活检以进行病理学和微生物学检查。

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