Septic arthritis associated with closed intra-articular fracture: a case series.

Abstract

Osteomyelitis in the setting of closed fractures is a recognized association in the literature, but to our knowledge, septic arthritis after a closed intra-articular fracture has not yet been reported. We conducted a retrospective review of 3 cases of septic arthritis after closed intra-articular fractures of the proximal phalanx of the great toe, distal tibia, and distal humerus. The patients presented with fever, erythema, pain, and elevated infectious indices. All patients had a delay in diagnosis of up to 10 days. On diagnosis, all patients underwent open irrigation and debridement and were treated with organism-specific antibiotics for Staphylococcus aureus or Streptococcus pneumoniae. One patient required metatarsophalangeal joint arthrodesis, whereas the other 2 patients returned to full function after a prolonged treatment course. Septic arthritis after closed intra-articular fracture is a rare clinical condition and requires prompt diagnosis and treatment. Level IV.