Similarities and Differences Between Diabetes-Related and Trauma-Related Calcaneal Osteomyelitis: Comparisons Based...

Area of Science:

• Orthopedics
• Infectious Diseases
• Diabetology

Background:

• Limited data exists on the clinical characteristics, diagnosis, and treatment of calcaneal osteomyelitis (CO).
• This study compares diabetes-related CO (DRCO) and trauma-related CO (TRCO) to elucidate their similarities and differences.

Purpose of the Study:

• To synthesize and compare the clinical features, diagnostic challenges, and treatment outcomes of DRCO and TRCO.
• To provide a comprehensive overview of DRCO and TRCO based on a literature review.

Main Methods:

• A systematic literature search was conducted in PubMed, Embase, and Cochrane Library for English studies published between January 2000 and December 2021.
• Data from 108 studies involving 278 DRCO and 403 TRCO patients were extracted and synthesized for comparative analysis.

Main Results:

• DRCO patients were older (median 56 vs 44 years), more often female (37.4% vs 24.3%), and presented with longer symptom duration compared to TRCO patients.
• Pathogen culture positivity was significantly higher in DRCO (94.8% vs 69.5%).
• DRCO patients faced higher risks of infection relapse (32.3% vs 16.3%), amputation (24.8% vs 1.4%), and all-cause mortality (4.9% vs 1.3%) than TRCO patients.

Conclusions:

• DRCO and TRCO share some clinical features and diagnostic considerations but exhibit distinct characteristics.
• The clinical efficacy and prognosis for DRCO are significantly worse compared to TRCO.