Patients with osteomyelitis require lengthy antibiotic treatment, often only to see the inflammation flare up once antibiotics are suspended. Unfortunately, patients often discontinue the antibiotic treatment due to c...Patients with osteomyelitis require lengthy antibiotic treatment, often only to see the inflammation flare up once antibiotics are suspended. Unfortunately, patients often discontinue the antibiotic treatment due to collateral effects. Patients with osteitis are often polymorbid patients with other severe diseases such as diabetes mellitus and polyneuropathy, arteriopathy or polyarthfitis with immunosuppression. The eight patients included in the study presented nine bones with osteomyelitis （macroscopically, bacteriologically, histologically or radiologically）. The diseased part of the bone was resected, a locally radical debridement was done and a biopsy for bacteriology and histology were taken. The residual bone was then drilled out and filled with antibiotic-loaded （gentamicin） resorbable bone-graft substitute under radiologic imaging control. In total, seven patients are currently without recurrent osteomyelitis with a mean follow-up of 5.77 months （2-11 months）. The Kaplan Meier curve shows 80% survival rate without recurrent osteomyelitis at 11 months. Only one patient suffering from Morbus Buerger had a relapse osteomyelitis after cutting off severing his foot while swimming in the sea. Antibiotic-loaded resorbable bone-graft substitute is easy to use, has in our hands few complications and low recurrence rate.展开更多
Objective： To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis i...Objective： To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs. Methods： Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis （8 cases of nonunion ） underwent one-stage allograft after debridement in our hospital. Results： Thirty-five cases were followed up for an average period of 28 months （ range, 13 to 55 months）, in which 32 cases （91.43%） were found no infection, and 3 cases （8.57%） were confirmed recurrence of infection. Four out of 8 cases of bone nonunion healed in 9.5 months on average （ range, 3 to 12 months）, and another case also acquired union after redebridement and autograft of iliumdue to infection recurrence 35 days after surgery. Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment. Conclusions： A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.展开更多
Skeletal tuberculosis developing after trauma is a rare occurrence. We report a rare case of posttraumatic tubercular osteomyelitis of mid-tarsal bone of the right foot. Patient was treated with regular dressing and a...Skeletal tuberculosis developing after trauma is a rare occurrence. We report a rare case of posttraumatic tubercular osteomyelitis of mid-tarsal bone of the right foot. Patient was treated with regular dressing and anti-tubercular drugs. Posttraumatic skeletal tuberculosis should be considered in patient with non-healing ulcer.展开更多
文摘Patients with osteomyelitis require lengthy antibiotic treatment, often only to see the inflammation flare up once antibiotics are suspended. Unfortunately, patients often discontinue the antibiotic treatment due to collateral effects. Patients with osteitis are often polymorbid patients with other severe diseases such as diabetes mellitus and polyneuropathy, arteriopathy or polyarthfitis with immunosuppression. The eight patients included in the study presented nine bones with osteomyelitis （macroscopically, bacteriologically, histologically or radiologically）. The diseased part of the bone was resected, a locally radical debridement was done and a biopsy for bacteriology and histology were taken. The residual bone was then drilled out and filled with antibiotic-loaded （gentamicin） resorbable bone-graft substitute under radiologic imaging control. In total, seven patients are currently without recurrent osteomyelitis with a mean follow-up of 5.77 months （2-11 months）. The Kaplan Meier curve shows 80% survival rate without recurrent osteomyelitis at 11 months. Only one patient suffering from Morbus Buerger had a relapse osteomyelitis after cutting off severing his foot while swimming in the sea. Antibiotic-loaded resorbable bone-graft substitute is easy to use, has in our hands few complications and low recurrence rate.
文摘Objective： To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs. Methods： Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis （8 cases of nonunion ） underwent one-stage allograft after debridement in our hospital. Results： Thirty-five cases were followed up for an average period of 28 months （ range, 13 to 55 months）, in which 32 cases （91.43%） were found no infection, and 3 cases （8.57%） were confirmed recurrence of infection. Four out of 8 cases of bone nonunion healed in 9.5 months on average （ range, 3 to 12 months）, and another case also acquired union after redebridement and autograft of iliumdue to infection recurrence 35 days after surgery. Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment. Conclusions： A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.
文摘Skeletal tuberculosis developing after trauma is a rare occurrence. We report a rare case of posttraumatic tubercular osteomyelitis of mid-tarsal bone of the right foot. Patient was treated with regular dressing and anti-tubercular drugs. Posttraumatic skeletal tuberculosis should be considered in patient with non-healing ulcer.
