Fracture union following internal fixation in the HIV population

IntroductionHIV is thought to be associated with increased rates of fracture non-union. We report on a prospective cohort of 96 HIV positive patients with 107 fractures that required internal fixation. The CD4 count was measured and patients were reviewed until eventual clinical or radiological union or non-union was established.ResultsFour percent of fractures (4 out of 100) failed to unite. Three patients required one further procedure to induce union, and two developed avascular necrosis. The CD4 count was not related to fracture union.ConclusionContrary to previous assumptions, this study suggests that HIV infection does not increase rates of non-union in surgically managed fractures.