Closed infected tibial plateau fracture and tibial tubercle avulsion: A case report

INTRODUCTION: Acute hematogenous osteomyelitis in a closed fracture usually occurs pediatric and/or immunocompromised patients and only rarely in an immunocompetent patient. CASE PRESENTATION: We report the case of a 44-year-old female patient who was diagnosed as acute hematogenous osteomyelitis in a tibial plateau fracture. Following a motorcycle accident she was diagnosed as having a subdural hematoma at the right parietal lobe and combined closed fracture of the left tibial plateau and avulsion of tibial tubercle. Intraoperatively a cloudy fluid was found at the fracture site of left tibial plateau that was cultured and grew Staphylococcus aureus. The risk factors for acute hematogenous osteomyelitis in a closed fracture of this patient were the subdural hematoma and multiple abrasion wounds around her left knee. CONCLUSION: Not only open fractures have a risk of acute hematogenous osteomyelitis but closed fractures also have a chance of developing this infection. The surgeon should be concerned about this type of infection if the patient has risk factors such as evidence of head injury or multiple abrasion wounds.