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

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An Erratum to this article was published on 06 June 2013


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.

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Correspondence to T. S. Howe.

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Howe, T.S., Erlich, G., Koh, J.S.B. et al. A case of an atypical femoral fracture associated with bacterial biofilm—pathogen or bystander?. Osteoporos Int 24, 1765–1766 (2013).

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