Sepsis and osteomyelitis about the ankle joint

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Trauma Care

Background:

• Ankle joint sepsis and osteomyelitis pose significant clinical challenges.
• Osteomyelitis frequently complicates open distal tibia fractures, particularly those involving pilon fractures.
• Hematogenous spread can lead to septic ankle arthritis.

Purpose of the Study:

• To outline strategies for preventing osteomyelitis in complex distal tibia and pilon fractures.
• To discuss treatment approaches for established osteomyelitis and sepsis of the ankle joint.
• To present the authors' experiences and insights into managing these challenging conditions.

Main Methods:

• Review of current literature and clinical guidelines for osteomyelitis prevention.
• Discussion of surgical and non-surgical treatment modalities for ankle osteomyelitis and sepsis.
• Analysis of case studies and clinical outcomes, including amputation rates.

Main Results:

• Effective prevention strategies are essential for reducing the incidence of osteomyelitis post-fracture.
• Multifaceted treatment approaches are required for managing established ankle infections.
• Below-knee amputation remains a necessary option for select patients with severe, refractory osteomyelitis and sepsis.

Conclusions:

• Proactive prevention of osteomyelitis in high-risk fractures is paramount.
• Comprehensive management, integrating surgical intervention and antimicrobial therapy, is key to treating ankle sepsis and osteomyelitis.
• Limb salvage should be balanced against the functional outcomes and patient well-being, with amputation considered when appropriate.