Thiam Desmond, Teo Tse Yean, Malhotra Rishi, Tan Kong Bing, Chee Yu Han
Department of Orthopaedics, National University Hospital, Singapore, Singapore.
Department of Pathology, National University Hospital, Singapore.
BMJ Case Rep. 2016 Jan 28;2016:bcr2015211915. doi: 10.1136/bcr-2015-211915.
Black bone disease refers to the hyperpigmentation of bone secondary to prolonged usage of minocycline. We present a report of a 34-year-old man who underwent femoral shaft fracture fixation complicated by deep infection requiring debridement. The implants were removed 10 months later after long-term treatment with minocycline and fracture union. A refracture of the femoral shaft occurred 2 days after implant removal and repeat fixation was required. Intraoperatively, abundant heavily pigmented and dark brown bone callus was noted over the old fracture site. There was no evidence of other bony pathology and the appearance was consistent with minocycline-associated pigmentation. As far as we are aware, this is the first case of black bone disease affecting callus within the interval period of bone healing. We also discuss the relevant literature on black bone disease to bring light on this rare entity that is an unwelcomed surprise to operating orthopaedic surgeons.
黑骨病是指长期使用米诺环素继发的骨色素沉着。我们报告一例34岁男性,其股骨干骨折内固定术后并发深部感染,需要清创。长期使用米诺环素并实现骨折愈合后,10个月后取出植入物。取出植入物2天后股骨干再次骨折,需要再次固定。术中发现,在原骨折部位有大量色素沉着明显的深褐色骨痂。没有其他骨病理的证据,其表现符合米诺环素相关色素沉着。据我们所知,这是第一例在骨愈合间隔期影响骨痂的黑骨病病例。我们还讨论了关于黑骨病的相关文献,以阐明这一罕见实体,它对于骨科手术医生来说是一个不受欢迎的意外。