Background and purposeTreatment failure of osteomyelitis can result from genetic susceptibility, highlighting polymorphisms of the interleukin-1 (IL-1) family members, central mediators of innate immunity and inflammation. Polymorphisms are DNA sequence variations that are common in the population (1% or more) and represent multiple forms of a single gene. We investigated the association of IL1RNVNTR (rs2234663) and IL1B-511C > T (rs16944) polymorphisms with osteomyelitis development in patients operated on because of bone trauma.Patients and methods153 patients who fulfilled the inclusion criteria were enrolled from a referral public hospital for trauma. All the patients were followed up daily until hospital discharge and, after this, on an outpatient basis. Patients were treated with prophylactic antimicrobials and surgery according to traumatology service protocol. The IL1RNVNTR and the IL1B-511C > T polymorphisms were determined by PCR and PCR-RFLP, respectively.ResultsThe IL1RN*2/*2 genotype was associated (OR: 7; p < 0.001) with a higher risk of osteomyelitis and was also significantly associated with Staphylococcus aureus infection. The haplotypes (combination of different markers) *2-C and *2-T were also associated with osteomyelitis development.InterpretationIL1B-511C > T and IL1RNVNTR polymorphisms were associated with osteomyelitis development, which may have implications for patients with bone traumas. These data may be relevant for new therapeutic strategies for this disease.

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Bilateral clavicle fractures are considered rare. Most of the cases are caused by high energy traumas, such as automobile accidents. Such fracture is related to a higher frequency and severity of associated lesions. In this report, the authors present a twenty-two-year-old male patient’s case who, after a motorcycle collision, suffered a bilateral medial end clavicle closed fracture, developing asymptomatic bilateral pseudoarthrosis after the patient refuses surgical treatment. The presented case is quite rare. Aspect related to the patient’s evolution during treatment will be discussed, plus the fracture mechanism, associated injuries, the bilateral clavicular fractures treatment, and management in cases of pseudoarthrosis will be analyzed.