title: Black bone disease in a healing fracture.
abstract: 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.
authors.affiliation: Department of Orthopaedics, National University Hospital, Singapore, Singapore.
authors.forename: Desmond
authors.initials: D
authors.lastname: Thiam
authors.affiliation: Department of Orthopaedics, National University Hospital, Singapore, Singapore.
authors.forename: Tse Yean
authors.initials: TY
authors.lastname: Teo
authors.affiliation: Department of Orthopaedics, National University Hospital, Singapore, Singapore.
authors.forename: Rishi
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Department of Pathology, National University Hospital, Singapore.
authors.forename: Kong Bing
authors.initials: KB
authors.lastname: Tan
authors.affiliation: Department of Orthopaedics, National University Hospital, Singapore, Singapore.
authors.forename: Yu Han
authors.initials: YH
authors.lastname: Chee
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001847:Bone Diseases / Q000139:chemically induced* / Q000473:pathology; D002146:Bony Callus / Q000187:drug effects / Q000473:pathology; D003646:Debridement / Q000379:methods*; D005264:Femoral Fractures / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008911:Minocycline / Q000008:administration & dosage / Q000009:adverse effects*; D012086:Reoperation; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008911:Minocycline
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