Evidence map›Paper›PMID 30255295›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2020

High prevalence of bacteria in clinically aseptic non-unions of the tibia and the femur in tissue biopsies.

Robin Otchwemah, Tobias Moczko, Benedikt Marche, Frauke Mattner, Christian Probst, Thorsten Tjardes

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Robin OtchwemahDepartment of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten-Herdecke (UWH), Ostmerheimerstr. 200, 51109, Cologne, Germany.
Tobias MoczkoDepartment of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten-Herdecke (UWH), Ostmerheimerstr. 200, 51109, Cologne, Germany.
Benedikt MarcheDepartment of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten-Herdecke (UWH), Ostmerheimerstr. 200, 51109, Cologne, Germany.
Frauke MattnerKliniken der Stadt Köln gGmbH, Institute of Hospital Hygiene, Köln-Merheim, Hospital of the Private University of Witten/Herdecke, Ostmerheimerstr. 22, 51109, Cologne, Germany.
Christian ProbstDepartment of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten-Herdecke (UWH), Ostmerheimerstr. 200, 51109, Cologne, Germany.
Thorsten TjardesDepartment of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten-Herdecke (UWH), Ostmerheimerstr. 200, 51109, Cologne, Germany. ttjardes@me.com.ORCID http://orcid.org/0000-0002-1952-6219

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere are several hints that bacterial colonization might be an often overseen cause of non-union. Modern procedures like PCR have been reported to diagnose bacterial colonization with a high degree of accuracy. While PCR is not ubiquitously available, we hypothesize that biopsies from the non-union site are comparable to PCR results reported in the literature.

methodsRetrospective analysis of microbiological results of biopsies from non-unions (femoral or tibial, history of revision surgery, and/or open fracture) with stable osteosynthesis, no clinical signs of local infection were analysed. CRP and leucocyte count were taken on admission. Multiple tissue samples (soft tissue and bone) were from the non-union (1-4 cm incision). Samples were cultivated for 2 weeks and tested following EUCAST protocols using VITEK

results11 tibia- and 7 femur non-union (44 ± 23.9 years), 11 open fractures (1 I°, 6 II°, 4 III° Gustillo Anderson), 0-5 revisions, and 4.1 (± 1.8) tissue samples were taken 8.5 (± 1.7) months after trauma. Cultures were positive in 8/18 (44,4%) (3/18 Propionibacterium acnes, 1/18 S. capitis, and 4/18 S. epidermidis). There was neither a correlation between number of biopsies taken and positive culture results (Pearson R: - 0.0503, R

conclusionThe results confirm that the presence of bacteria in cases with no clinical signs of infection is a relevant issue. The prevalence of bacteria reported here is comparable that reported from cohorts tested with PCR or sonication. In most cases, there was only one positive biopsy, raising the question whether a contamination has been detected. Thus, to better understand the problem, it is necessary to gather more knowledge regarding the sensitivities and specificities of the different diagnostic procedures.

Indexed as

AdultBiopsyFemoral FracturesFracture Fixation, InternalFracture HealingFractures, UnunitedHumansMiddle AgedPolymerase Chain ReactionPrevalenceRetrospective StudiesSurgical Wound InfectionTibial FracturesNon-unionOsteitisPCRTibia

Identifiers

PMID30255295

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.