, Volume 24, Issue 5, pp 1765-1766
Date: 15 Nov 2012

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

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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.

An erratum to this article can be found at http://dx.doi.org/10.1007/s00198-013-2406-6.