The management of chronic osteomyelitis using the Lautenbach method

Area of Science:

• Orthopedics
• Infectious Diseases
• Surgical Innovation

Background:

• Chronic osteomyelitis in long bones presents a significant challenge, often with prolonged infection duration and associated complications like non-union or malunion.
• Traditional treatments involving debridement and antibiotics have limitations in eradicating long-standing infections and achieving complete bone healing.

Purpose of the Study:

• To evaluate the medium-term outcomes of the Lautenbach procedure for managing chronic osteomyelitis in long bones.
• To assess the efficacy of this technique in achieving infection clearance, cavity obliteration, and limb salvage.

Main Methods:

• Prospective study of 17 patients (18 segments) with chronic osteomyelitis treated with the Lautenbach procedure.
• The procedure includes debridement, intramedullary reaming, and double-lumen tubes for local antibiotic delivery and cavity monitoring.
• Treatment endpoint defined by clear cultures, improved blood indices, and cavity obliteration.

Main Results:

• All patients achieved infection clearance with a mean follow-up of 75 months.
• Mean treatment duration was 27 days, with low rates of recurrence requiring additional intervention.
• Successful management of associated fractures and bone defects was noted in many patients.

Conclusions:

• The Lautenbach procedure offers precise control for chronic osteomyelitis, leading to sustained infection eradication and cavity obliteration.
• This technique is recommended for complex, long-standing cases refractory to conventional treatments.
• The procedure facilitates subsequent management of orthopedic complications and limb salvage.