Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report

Introduction: Several studies have proposed a relationship between the coronavirus disease 2019 (COVID-19)-induced cytokine storm and prohibitive effects on the musculoskeletal system, including increased risk of fracture, osteoporosis, and impaired bone healing. To our knowledge, this is the first...

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Main Authors: Amy Singleton, Anthony J Mancuso II, Samuel G Eaddy, Seth Phillips
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-02-01
Series:Journal of Orthopaedic Case Reports
Subjects:
Online Access:https://jocr.co.in/wp/2025/02/01/non-union-of-a-tibial-plafond-fracture-in-a-covid-positive-patient-a-case-report/
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author Amy Singleton
Anthony J Mancuso II
Samuel G Eaddy
Seth Phillips
author_facet Amy Singleton
Anthony J Mancuso II
Samuel G Eaddy
Seth Phillips
author_sort Amy Singleton
collection DOAJ
description Introduction: Several studies have proposed a relationship between the coronavirus disease 2019 (COVID-19)-induced cytokine storm and prohibitive effects on the musculoskeletal system, including increased risk of fracture, osteoporosis, and impaired bone healing. To our knowledge, this is the first known case report involving a fracture non-union concomitant with COVID-19 infection and apparent cytokine storm. Case Report: A 47-year-old male presented with an open pilon fracture of the left ankle after falling off a 6-foot ladder. At his 4-month post-operative follow-up, the patient attempted to ambulate without his cam boot for the 1st time, causing acute displacement of his poorly healed tibia fracture. A non-union laboratory workup demonstrated elevated inflammatory markers indicative of septic non-union; however, the patient also tested positive for severe acute respiratory syndrome coronavirus 2 at this time. Because of this, antibiotic treatment was not initiated due to suspicion of a cytokine storm. One month later, the patient’s inflammatory markers had decreased and he underwent revision surgery. Conclusion: This case underscores the potential impact of COVID-19 on fracture healing and the importance of vigilant monitoring and differential diagnosis in managing non-union in COVID-19-positive patients.
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spelling doaj-art-1cff7ffe2cfa450d86a9b053c3ca53b42025-08-20T03:31:24ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-02-01152111510.13107/jocr.2025.v15.i02.5210Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case ReportAmy SingletonAnthony J Mancuso IISamuel G EaddySeth PhillipsIntroduction: Several studies have proposed a relationship between the coronavirus disease 2019 (COVID-19)-induced cytokine storm and prohibitive effects on the musculoskeletal system, including increased risk of fracture, osteoporosis, and impaired bone healing. To our knowledge, this is the first known case report involving a fracture non-union concomitant with COVID-19 infection and apparent cytokine storm. Case Report: A 47-year-old male presented with an open pilon fracture of the left ankle after falling off a 6-foot ladder. At his 4-month post-operative follow-up, the patient attempted to ambulate without his cam boot for the 1st time, causing acute displacement of his poorly healed tibia fracture. A non-union laboratory workup demonstrated elevated inflammatory markers indicative of septic non-union; however, the patient also tested positive for severe acute respiratory syndrome coronavirus 2 at this time. Because of this, antibiotic treatment was not initiated due to suspicion of a cytokine storm. One month later, the patient’s inflammatory markers had decreased and he underwent revision surgery. Conclusion: This case underscores the potential impact of COVID-19 on fracture healing and the importance of vigilant monitoring and differential diagnosis in managing non-union in COVID-19-positive patients.https://jocr.co.in/wp/2025/02/01/non-union-of-a-tibial-plafond-fracture-in-a-covid-positive-patient-a-case-report/pilon fracturetibial plafond fracturedelayed unionnon-unioncoronavirus disease 19cytokine stormrevision
spellingShingle Amy Singleton
Anthony J Mancuso II
Samuel G Eaddy
Seth Phillips
Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report
Journal of Orthopaedic Case Reports
pilon fracture
tibial plafond fracture
delayed union
non-union
coronavirus disease 19
cytokine storm
revision
title Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report
title_full Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report
title_fullStr Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report
title_full_unstemmed Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report
title_short Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report
title_sort non union of a tibial plafond fracture in a covid positive patient a case report
topic pilon fracture
tibial plafond fracture
delayed union
non-union
coronavirus disease 19
cytokine storm
revision
url https://jocr.co.in/wp/2025/02/01/non-union-of-a-tibial-plafond-fracture-in-a-covid-positive-patient-a-case-report/
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AT anthonyjmancusoii nonunionofatibialplafondfractureinacovidpositivepatientacasereport
AT samuelgeaddy nonunionofatibialplafondfractureinacovidpositivepatientacasereport
AT sethphillips nonunionofatibialplafondfractureinacovidpositivepatientacasereport