Case ReportNo Access

Fracture of the Distal Radius by Tuberculous Osteomyelitis: A Case Report and Review of Literature

Orthopaedics and Traumatology Department, Complexo Hospitalario Universitario de Vigo-Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor, 341, 36213 Vigo, Pontevedra, Spain

E-mail Address: alejandro.garcia.reza@sergas.es

Correspondence to: Alejandro Garcia-Reza, Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor, 341, Vigo, CP: 36212, Pontevedra, Spain. Tel: +34620768659.

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Manuel CASTRO-MENENDEZ

Orthopaedics and Traumatology Department, Complexo Hospitalario Universitario de Vigo-Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor, 341, 36213 Vigo, Pontevedra, Spain

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Diego DOMINGUEZ-PRADO

Orthopaedics and Traumatology Department, Complexo Hospitalario Universitario de Vigo-Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor, 341, 36213 Vigo, Pontevedra, Spain

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Javier YAÑEZ-CALVO

Orthopaedics and Traumatology Department, Complexo Hospitalario Universitario de Vigo-Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor, 341, 36213 Vigo, Pontevedra, Spain

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https://doi.org/10.1142/S2424835522720183Cited by:2 (Source: Crossref)

Abstract

We report a 94-year-old patient with a fractured radius that was being managed conservatively. At 2 months, an abscess was observed overlying the fracture site. An MRI scan was done and samples obtained for microbiological and pathological analyses. The patient was diagnosed with tuberculous osteomyelitis. Surgical debridement of the fracture site was performed, and the bone defect was filled with bone cement impregnated with gentamicin and rifampicin. Anti-tuberculosis therapy was administered for 9 months and the patient made an uneventful recovery. Early diagnosis and correct medical treatment depend on sound evidence of tuberculous osteomyelitis. Surgical debridement is essential if abscesses are present in the bone.

Level of Evidence: Level V (Therapeutic)

Keywords:

REFERENCES

1. Sarkar AS, Garg AK, Bandyopadhyay A, Kumar S, Pal S. Tuberculosis of distal radius presenting as cystic lesion in a nine-month-old infant: A rare case report. J Clin Diagn Res. 2016;10(9):RD06–RD07. https://doi.org/10.7860/JCDR/2016/19916.8564. Crossref, Google Scholar
2. Lemnouer A, Frikh M, Belfquih B, et al.. Navicular tuberculosis: A rare localization of bone tuberculosis. IDCases. August 19, 2015;2(3):80–82. https://doi.org/10.1016/j.idcr.2015.08.002.3. Crossref, Google Scholar
3. Sbai MA, Benzarti S, Bouzaidi K, Sbei F, Maalla R. A rare localization of tuberculosis of the wrist: The scapholunate joint. Int J Mycobacteriol. June 2015;4(2):161–164. https://doi.org/10.1016/j.ijmyco.2015.04.001. Crossref, Google Scholar
4. Lazrek O, Bassir RA, Sabri EM, et al.. Tuberculosis of radius diaphysis: Case report and review of literature. Int J Mycobacteriol. July-September 2018;7(3):292–294. https://doi.org/10.4103/ijmy.ijmy_81_18. Crossref, Google Scholar
5. Birole U, Ranade A, Mone M. A case report of an unusual case of tuberculous osteomyelitis causing spontaneous pathological fracture of humerus in a middle aged female. J Orthop Case Rep. January-February 2017;7(1):41–45. https://doi.org/10.13107/jocr.2250-0685.680. Crossref, Google Scholar
6. Seddon DJ, Thanabalasingham T, Weinberg J. Spontaneous fracture of the ulna complicating tuberculous osteomyelitis. Postgrad Med J. December 1989;65(770):939–940. https://doi.org/10.1136/pgmj.65.770.939. Crossref, Google Scholar
7. Johansen IS, Nielsen SL, Hove M, et al.. Characteristics and clinical outcome of bone and joint tuberculosis from 1994 to 2011: A retrospective register-based study in Denmark. Clin Infect Dis. August 15, 2015;61(4):554–562. https://doi.org/10.1093/cid/civ326. Crossref, Google Scholar
8. Lopes MJ, Furtado I, Brandão M, Farinha F. Tuberculous osteomyelitis of the wrist presenting as a monoarthritis syndrome. BMJ Case Rep. February 6, 2018;2018:bcr2017222136. https://doi.org/10.1136/bcr-2017-222136. Crossref, Google Scholar
9. Han CD, Oh T, Cho SN, Yang JH, Park KK. Isoniazid could be used for antibiotic-loaded bone cement for musculoskeletal tuberculosis: An in vitro study. Clin Orthop Relat Res. July 2013;471(7):2400–2406. https://doi.org/10.1007/s11999-013-2899-5. Crossref, Google Scholar