Pathological fracture complicating long bone osteomyelitis in patients with sickle cell disease

Pathological fracture of long bones occurred in 26 of 129 (20.2%) consecutive patients with sickle cell disease and osteomyelitis. The 26 patients were in either the first (17 subjects) or second (nine subjects) decade of life. The male:female ratio was 9:4. The fracture was significantly more common in acute than in chronic osteomyelitis (p less than 0.05) and in gram-negative than in staphylococcal infection (p less than 0.0001). Therefore, acute long bone osteomyelitis in young patients with sickle cell disease should be immobilized rigidly early and until sufficient new bone has formed, particularly in young West African boys with whole diaphyseal, gram-negative infection.