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Treatment of chronic osteomyelitis using the Papineau technique
M Panda1, N Ntungila, M Kalunda
1Service d'Orthopédie Traumatologie, Cliniques Universitaires de Kinshasa, République Démocratique du Congo.
Abstract:
From 1984 to 1994, 41 cases of chronic osteomyelitis were treated in Kinshasa by the Papineau technique; 75.5% were men and 24.5% women. The mean age was 28 years (range: 7-77), and the average duration of the infection was 3 years (range: 1 month to 28 years). The aetiology was "trauma" in 53.5%, haematogenous in 44% and drepanocytosis in 2.5%. Infections of the femur and tibia each constituted 41.5% of the cases. Immobilisation was by external fixation in 44%, and by a cast in 39%. Wound healing was complete after an average of 3 months with spontaneous healing, and in 4.5 months after skin grafting. Control of the infection and bone healing were obtained in 89% after a period of 3-7 months. We discuss the Papineau technique and the modifications which were required in Kinshasa.
Insights
The Papineau technique effectively treated chronic osteomyelitis in Kinshasa, achieving an 89% success rate for infection control and bone healing. This study highlights its efficacy in managing complex bone infections.
Area of Science:
- Orthopedics
- Infectious Diseases
- Surgical Techniques
Background:
- Chronic osteomyelitis presents a significant challenge in resource-limited settings.
- The Papineau technique is a reconstructive surgical method for treating bone infections.
- Data on the Papineau technique's application in African populations is limited.
Purpose of the Study:
- To evaluate the efficacy of the Papineau technique in treating chronic osteomyelitis in Kinshasa.
- To analyze patient demographics, etiological factors, and treatment outcomes.
- To discuss necessary modifications of the technique for local conditions.
Main Methods:
- A retrospective review of 41 chronic osteomyelitis cases treated with the Papineau technique between 1984 and 1994.
- Data collected included patient demographics, infection duration, etiology, affected bones, immobilization methods, and healing times.
- Outcomes assessed were wound healing and control of infection with bone healing.
Main Results:
- The study included 75.5% males, with a mean age of 28 years and average infection duration of 3 years.
- Trauma (53.5%) and hematogenous (44%) causes were predominant, with femur and tibia infections being most common (41.5% each).
- An 89% success rate for infection control and bone healing was achieved within 3-7 months, with wound healing averaging 3 months (spontaneous) to 4.5 months (grafting).
Conclusions:
- The Papineau technique, with modifications, demonstrated high efficacy in treating chronic osteomyelitis in Kinshasa.
- The findings support the use of this technique in similar settings, emphasizing adaptability to local challenges.
- Successful management involved addressing trauma, hematogenous spread, and specific immobilization techniques.