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Hemidiaphysectomy to control chronic osteomyelitis.

G D Rovere, M L Mattern

    Southern Medical Journal
    |July 1, 1978
    PubMed
    Summary
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    A novel surgical technique successfully removed a retained, bent Küntscher nail (intramedullary fixation device) complicating chronic osteomyelitis. This approach facilitated bone healing and restored full patient function without complications.

    Area of Science:

    • Orthopedic Surgery
    • Infectious Disease Management

    Background:

    • Chronic osteomyelitis presents significant challenges, often requiring complex surgical interventions.
    • Retained intramedullary nails can complicate infection management and impede treatment.
    • Standard nail removal techniques may be insufficient for bent or impacted devices.

    Observation:

    • A 34-year-old male patient presented with chronic osteomyelitis of the left femur, complicated by a retained, bent Küntscher nail.
    • The bent nail prevented removal via routine methods, necessitating an alternative surgical strategy.

    Findings:

    • A hemidiaphysectomy of the femur enabled straightforward removal of the problematic Küntscher nail.
    • Radical curettage addressed the chronically infected intramedullary granulation tissue.

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  • The resected diaphyseal segment was replaced without internal fixation, leveraging the thickened bone from osteomyelitis for stability.
  • Postoperative external fixation was deemed unnecessary due to significant femoral sclerosis.

    • Implications:

    • This surgical approach offers a viable solution for managing complex cases of retained, bent intramedullary nails in the context of chronic osteomyelitis.
    • Successful bone healing and functional recovery were achieved, highlighting the efficacy of the technique.
    • The findings suggest that bone hypertrophy secondary to chronic osteomyelitis can provide sufficient stability, potentially obviating the need for external fixation.