Chronic Clostridium septicum infection of a tibial fracture: a case report

An open transverse fracture of the mid-shaft of the tibia of a professional footballer became infected by Clostridium septicum and, after early compression plating, required surgical intervention on three further occasions and extensive antibiotic treatment before healing occurred. Clostridial infection is a recognized complication of open fractures contaminated with soil, and the necrotizing toxins produced by the C. septicum were probably responsible for the persistence of this infection. Infection occurred in less than 1 per cent of our series of 215 operations of compression plating of fresh fractures of the tibial shaft. Infection by clostridium species is a serious complication of open fractures. This patient did not show the spreading inflammation and necrosis, or the marked systemic upset, characteristic of acute clostridial infection, but persistent local infection necessitated prolonged surgical and antibiotic treatment.