%0 Journal Article
%T Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques
%A Justus Gille
%A Steffen Wallstabe
%A Arndt-Peter Schulz
%A Andreas Paech
%A Ulf Gerlach
%J Journal of Orthopaedic Surgery and Research
%D 2012
%I BioMed Central
%R 10.1186/1749-799x-7-20
%X A 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.23 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/¦Ìl) 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.The combination of microbiological culture and broad-range PCR seems to substantially add to the number of microbiological diagnoses obtained and may improve the clinican¡¯s ability to tailor therapy to the individual patient¡¯s needs.
%K Non-union
%K Tibial fracture
%K Low-grade infection
%K Molecular diagnosis
%K PCR technique
%U http://www.josr-online.com/content/7/1/20/abstract