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Septic arthritis associated with closed intra-articular fracture: a case series
Vedant A Kulkarni1, Eric Schiffman, Avi C Baitner
1Department of Orthopaedic Surgery, University of California, San Diego Medical Center, San Diego, CA 92103-8894, USA. vkulkarni@ucsd.edu
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
Septic arthritis after closed intra-articular fracture is a rare clinical condition and requires prompt diagnosis and treatment.
Level Of Evidence:
Level IV.
