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[Chronic osteomyelitis: one-step treatment].

G Rizzello1, M C Meloni, M Ippolito

  • 1Policlinico Universitario Campus Bio-Medico Roma, Italia. g.rizzello@unicampus.it

La Clinica Terapeutica
|August 12, 2006
PubMed
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This study presents a one-step surgical treatment for chronic osteomyelitis of the humerus, achieving successful eradication of infection and promoting natural wound healing. The approach involves debridement and leaving the wound open for drainage, leading to positive outcomes in post-traumatic cases.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Trauma Management

Background:

  • Chronic osteomyelitis is a challenging surgical condition often resulting from trauma, particularly open fractures of long bones.
  • Post-traumatic osteomyelitis, especially following surgical treatment like osteosynthesis, requires dedicated management strategies.
  • This case report focuses on chronic osteomyelitis of the humerus secondary to trauma.

Observation:

  • A 34-year-old male patient presented with chronic osteomyelitis of the humerus following an open diaphyseal fracture.
  • The patient underwent a one-step surgical procedure.
  • The surgical intervention included fistulectomy, sequestrectomy, and opening of the intramedullary canal.

Findings:

  • The one-step surgical treatment resulted in no secretion and negative cultures at 30-day follow-up.

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  • The surgical site exhibited second-intention healing of the skin.
  • The procedure successfully addressed the infected bone and soft tissue without immediate reconstruction.

    • Implications:

    • Effective management of chronic osteomyelitis necessitates pathogen identification and thorough debridement of all infected and necrotic material.
    • Leaving surgical foci open with external drainage aids in tissue sterilization and facilitates healing.
    • A one-stage surgical approach can successfully resolve chronic post-traumatic osteomyelitis, allowing for spontaneous skin defect healing without the need for immediate bony or soft tissue reconstruction.