RESUMO
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.
RESUMO
INTRODUCTION: CCR5 receptor exerts an important role in the host immune response. Osteomyelitis is an inflammatory process and Staphylococcus aureus is the principal causative agent of this bone injury complication. A deletion of 32bp (CCR5Δ32) in the CCR5 gene seems to protect against HIV-1, S.aureus and other infections. However, the CCR5Δ32 allele has been associated with an increased risk for other diseases. OBJECTIVE: To investigate the function of CCR5 and to gather data about the relationship of the CCR5Δ32 mutation and the risk of developing osteomyelitis as a complication in patients with bone traumas. METHODS: In a study of 153 patients with bone traumas the presence of the CCRΔ32 mutation was determined by PCR. RESULTS: In this study, the CCR5Δ32 allele was present only in the heterozygous form. Osteomyelitis was more frequent in the wild type carriers (94.87%; 37/39) and most of the CCR5Δ32 carriers (87.5%; 14/16) did not present with osteomyelitis. CONCLUSION: The CCR5Δ32 could be associated with protection against osteomyelitis caused by S. aureus, corroborating the data from Alonzo & Torres study, in which CCR5 receptor is required for S. aureus leukotoxin ED (LukED) cytotoxicity.