A case of an atypical femoral fracture associated with bacterial biofilm--pathogen or bystander?

Howe, T S; Ehrlich, G D; Koh, J S B; Ng, A C M; Costerton, W · Osteoporos Int · 2013

case_report · Level V

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Abstract

We report a case of an 86-year-old woman with an atypical femoral fracture (AFF) who was treated with intramedullary nailing followed by lateral femoral plating. She developed a second femoral shaft fracture distal to the intramedullary nail which required a second operation. Biopsy of the periosteum overlying the site of the initial proximal AFF was sent for pathogen analysis. Using the Ibis T5000 platform and the BAC plate assay, a polymicrobial infection was diagnosed consisting of Bifidobacterium subtile and Pseudomonas mendocina. This raises the possibility that bacterial infections may play some role in atypical fractures of the femur.

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