Browse > Article

Delayed Foreign Body Reaction around the Absorbable Implants in Facial Bone Fracture: A Case Report  

Suh, Yong-Hoon (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine)
Kim, Young-Joon (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine)
Publication Information
Archives of Plastic Surgery / v.38, no.6, 2011 , pp. 875-878 More about this Journal
Abstract
Purpose: Absorbable implants are frequently used to fix facial bone fractures, because they are radiolucent and compatible with magnetic resonance imaging (MRI). Despite their increasing usage, however, there have been few reports about their long-term side-effects. In this paper, a case in which absorbable implants led to a foreign body reaction 17 months after their insertion is presented. Methods: A previously healthy 19-year-old male fell from a flight of stairs and visited the authors' hospital with right periorbital pain. Zygomaticomaxillary fracture involving right orbital floor was detected via a facial bone computed tomography (CT). Internal fixation with absorbable implants was followed by open reduction. 17 months after the surgery, the patient complained of localized periorbital swelling. Removal of the granulomatous lesion including the absorbable implants along with their biopsy and culture was performed. Results: The granulomatous lesion around the implants was firm and extended into the maxillary sinus. The histologic finding showed a microabscess with a foreign body reaction. Methicillin-sensitive Staphylococcus aureus growth was confirmed in the culture. No definite abnormal symptoms ensued after the complete removal. Conclusion: A microabscess-forming granulomatous lesion around the absorbable implant can cause delayed symptomatic foreign body reaction despite its rare occurrence. Complete removal of the lesion including implants is expected to have a successful outcome if it is encountered.
Keywords
Foreign body reaction; Absorbable implant;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Enislidis G, Pichorner S, Lambert F, Wagner A, Kainberger F, Kautzky M, Ewers R: Fixation of zygomatic fractures with a new biodegradable copolymer osteosynthesis system. preliminary results. Int J Oral Maxillofac Surg 27: 352, 1998   DOI   ScienceOn
2 Suuronen R, Haers PE, Lindqvist C, Sailer HF: Update on bioresorbable plates in maxillofacial surgery. Facial Plast Surg 15: 61, 1999   DOI
3 Losken HW, van Aalst JA, Mooney MP, Godfrey VL, Burt T, Teotia S, Dean SB, Moss JR, Rahbar R: Biodegradation of Inion fast-absorbing biodegradable plates and screws. J Craniofac Surg 19: 748, 2008   DOI   ScienceOn
4 Enislidis G, Lagogiannis G, Wittwer G, Glaser C, Ewers R: Fixation of zygomatic fractures with a biodegradable copolymer osteosynthesis system: short- and long-term results. Int J Oral Maxillofac Surg 34: 19, 2005
5 Abou-Hamad W, Matar N, Elias M, Nasr M, Sarkis-Karam D, Hokayem N, Haddad A: Bacterial flora in normal adult maxillary sinuses. Am J Rhinol Allergy 23: 261, 2009   DOI
6 Wittwer G, Adeyemo WL, Yerit K, Voracek M, Turhani D, Watzinger F, Enislidis G: Complications after zygoma fracture fixation: is there a difference between biodegradable materials and how do they compare with titanium osteosynthesis? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101: 419, 2006   DOI   ScienceOn
7 Ashammakhi N, Peltoniemi H, Waris E, Suuronen R, Serlo W, Kellomaki M, Tormala P, Waris T: Developments in craniomaxillofacial surgery: use of self-reinforced bioabsorbable osteofixation devices. Plast Reconstr Surg 108: 167, 2001   DOI   ScienceOn
8 Sanger C, Soto A, Mussa F, Sanzo M, Sardo L, Donati PA, Di Pietro G, Spacca B, Giordano F, Genitori L: Maximizing results in craniofacial surgery with bioresorbable fixation devices. J Craniofac Surg 18: 926, 2007   DOI   ScienceOn