Intraoperative findings during implant removal were significant for a hyperpigmented brown-black callus over the exposed anterior and lateral aspects of the old fracture site. Planned removal of the femoral plating and screws was then carried out. Treatment continued for the subsequent 10 months by which point the patient had already been ambulating pain-free, and there was deemed to be adequate union on interval radiographs. Removal of implants at the earliest possibility was also recommended in order to discontinue minocycline. This was implemented to prevent the possible risk of deep infection or osteomyelitis development given the proximity of the infection to the implant. The patient’s wounds healed well and he was discharged with long-term minocycline 100 mg twice daily. Clinically, the haematoma was in the muscular plane and not in contact with the fracture site, but an infectious diseases consult was sought and the patient was initiated on minocycline based on sensitivities. Cultures of the haematoma yielded growth of the bacteria Elizabethkingia meningoseptica. The haematoma was explored and washed out and causative muscular bleeders were ligated. This was complicated by fever and haematoma formation adjacent to the inferior part of the implant. Open reduction and internal fixation with femoral plating was performed. There was no history of fragility fractures. He had no medical conditions and was a non-smoker. A 34-year-old man presented with a closed fracture of the left femoral shaft as a result of a road traffic accident.
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