Pathological Fracture of the Femur Following Chronic Osteomyelitis: A Case Report of This Rare Presentation in Adults

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 5; p. e59733
• Main Authors: Botterill, Jonathan, Ghosh, Soubhik, Bhaskaran, Arun
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 06-05-2024; Cureus
• Subjects: Abscesses; Antibiotics; Bone marrow; Case reports; Diverticulitis; E coli; Emergency medical care; Enzymes; Fistula; Fractures; Infections; Orthopedics; Trauma; osteomyelitis; infection; thigh abscess; colovesical fistula; pathological fracture
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.59733

Chronic osteomyelitis is a common presentation in orthopaedics, particularly in the context of deep abscesses. Fractures related to osteomyelitis can be seen in children but are rare in adults. We present the rare case of a pathological fracture related to osteomyelitis in a 53-year-old warehouse worker who was previously fit and well. He presented with a right-sided thigh abscess and after initial surgical management, further imaging detailed osteomyelitis that was treated with suppressive antimicrobial therapy. Seven months after discharge, the patient presented to our emergency department with a right-sided proximal fracture of the femur. Retrospectively, we were able to localise the fracture site to the site of the previous cloaca from the osteomyelitis. We discuss whether prophylactic fixation is required for patients with extensive cloaca following a chronic fracture.