The treatment of chronic osteomyelitis in sickle cell anemia

A series of twenty patients with either sickle cell anemia (HbS) or sickle cell-hemoglobin C disease (S+C disease) treated by sequestrectomy or saucerization for troublesome chronic osteomyelitis in twenty-five long bones is reviewed. No special preoperative preparation was undertaken, and no deaths or postoperative complications resulted from this omission. Good results were obtained in 68% of the bones operated on. The patients were followed up for an average of four years and three months. The best results were obtained in those patients with cortical sequestra. Adult osteomyelitis, infection of several years duration and highly resistant organisms were associated with poor results. It was observed that surgical treatment of chronic osteomyelitis in these patients was safe, and the results were comparable to those obtained in patients with normal hemoglobin electrophoretic patterns (HbA). Therefore, where indicated, these patients should be given the benefit of surgery without undue delay.