Der Unfallchirurg
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This report describes the procedures applied to remove a metal foreign body retained inside the ulnar nerve in the distal humerus of a 49-year-old patient. Exemplified by an unfavorable primary treatment this article presents the first description of removal of an foreign body retained within a nerve whereby emphasis is placed on the problems associated with the preoperative and intraoperative localization of the foreign particle.
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The development of modular prostheses is becoming increasingly important in revision surgery due to the rising need of arthroplasty in knee and hip joints. The demand for suitable prostheses is high because of the desire for a higher mobility and a good postoperative functionality, whereby preliminary experience with megaprostheses using modular implant systems in orthopedic oncology have already been obtained. Considering the clinical outcome of our 58-year-old patient (obesity III, BMI 58) and the third revision operation after two periprosthetic fractures, a megaprosthesis was implanted (Mega C-system, co. ⋯ Postoperatively, a good clinical outcome after intensive physiotherapy was observed. Nevertheless, the use of megaprostheses has to be judged cautiously because of a lack of long-term results. In addition, it should not be used as a standard implant in periprosthetic joint surgery because of the risk of aseptic loosening during its course.