ArticleJournal of orthopaedic surgery and research2012
Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques.
Article in Journal of orthopaedic surgery and research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Surprise positive culture rate in the treatment of presumed aseptic long-bone nonunion: a systematic review with meta-analysis of 2397 patients.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Systematic investigation and comparison of diagnostic methods in implant-related infections and infectious non-unions in trauma surgery- results of a prospective study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Long-Term Outcomes Following Single-Stage Reamed Intramedullary Exchange Nailing in Apparently Aseptic Femoral Shaft Nonunion with Unsuspected Proof of Bacteria.Journal of clinical medicine · 2024Article
- Universal PCR for bacteria, mycobacteria, and fungi: a 10-year retrospective review of clinical indications and patient outcomes.Journal of clinical microbiology · 2023Article
- High prevalence of bacteria in clinically aseptic non-unions of the tibia and the femur in tissue biopsies.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Article
- Recommendations for Systemic Antimicrobial Therapy in Fracture-Related Infection: A Consensus From an International Expert Group.Journal of orthopaedic trauma · 2020Article
- Functional outcome of septic arthritis after anterior cruciate ligament surgery.International orthopaedics · 2015Article
- Biological and molecular profile of fracture non-union tissue: current insights.Journal of cellular and molecular medicine · 2015Review
- Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections.Advances in wound care · 2015Review
- Periprosthetic Tibial Fracture with Nonunion and Ascending Prosthetic Joint Infection: A Case Report of an Individual Treatment Strategy.Journal of orthopaedic case reportsArticle
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-union continues to be one of the orthopedist's greatest challenges. Despite effective culture methods, the detection of low-grade infection in patients with non-union following tibial fracture still presents a challenge. We investigated whether "aseptic" tibial non-union can be the result of an unrecognized infection.
methodsA total of 23 patients with non-union following tibial shaft fractures without clinical signs of infection were investigated. Intraoperative biopsy samples obtained from the non-union site were examined by means of routine culture methods and by polymerase chain reaction (PCR) for the detection of 16 S ribosomal RNA (rRNA). Control subjects included 12 patients with tibial shaft fractures.
results23 patients (8 women and 15 men; mean age: 47.4 years) were included into this study. Preoperative C-reactive protein levels (mean: 20.8 mg/l) and WBC counts (mean: 8,359/μl) in the study group were not significantly higher than in the control group. None of the samples of non-union routine cultures yielded microorganism growth. Bacterial isolates were found by conventional culturing methods in only 1 case of an open fracture from the control group. In this case, PCR yielded negative results. 16 S rRNA was detected in tissue specimens from 2 patients (8.7%) with non-union. The analysis of these variable species-specific sequences enabled the identification of specific microorganisms (1x Methylobacterium species, 1x Staphylococcus species). Both PCR-positive patients were culture-negative.
conclusionsThe combination of microbiological culture and broad-range PCR seems to substantially add to the number of microbiological diagnoses obtained and may improve the clinician's ability to tailor therapy to the individual patient's needs.
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