Delayed foreign body reaction after fixation of distal radius fracture with biodegradable implant

Biodegradable implants made of polylactic acid have been used in orthopedic surgery for several decades. However, the potential complication of foreign body reaction was still reported, with varied incidence after implantation. We report a case who received open reduction and internal fixation for a distal radius fracture with a biodegradable plate and screws. A painful nodule developed at the surgical site after 18 months of implantation. The nodule was excised and histology confirmed the diagnosis of lightly eosinophilic particles of different sizes and foreign body reaction. It occurred in a non-typical location for this material. The biodegradable materials designed for fracture fixation should consider not only providing sufficient mechanical strength for the bone to heal, but also minimizing the risk of foreign body reactions as well. Further research and development for a better biodegradable material is still needed.