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Severe bone wax foreign-body reaction causing peroneal tendon destruction
Journal of the American Podiatric Medical Association
|February 13, 2015
Summary
Bone wax, used for orthopedic bleeding control, can cause granulomas. This case shows bone wax granuloma leading to severe peroneal tendon and nerve damage, a previously undocumented complication.
Area of Science:
- Orthopedic Surgery
- Surgical Pathology
- Biomaterials Science
Background:
- Bone wax is a standard hemostatic agent in orthopedic surgery, particularly for controlling bleeding from cancellous bone.
- Its application is widespread in various bone procedures, including osteotomies and resections.
Observation:
- A patient developed a symptomatic retrofibular mass five months after peroneal tubercle resection where bone wax was used for hemostasis.
- The mass was associated with severe destruction of the peroneal tendon upon surgical removal.
Findings:
- Microscopic examination confirmed the retrofibular mass as a bone wax foreign-body granuloma.
- This represents the first reported instance of significant peroneal tendon and nerve damage attributed to a bone wax granuloma.
Implications:
- This case highlights a rare but severe complication of bone wax, emphasizing the potential for foreign-body reactions.
- Clinicians should be aware of the possibility of delayed complications, including granuloma formation and associated tissue damage, even with commonly used hemostatic agents.
- Further research into the long-term biocompatibility and potential inflammatory responses to bone wax may be warranted.
