Treatment of chronic tibial osteomyelitis: a case report and a literature review
DOI:
https://doi.org/10.1016/j.rccot.2017.01.005Keywords:
chronic osteomyelitis, tibia, nailing custom-made, UHMWP beadsAbstract
Osteomyelitis is a bone infection that is declining in recent years since the use of antibiotic therapy, but those that are presented are therefore difficult to treat or occur in high risk patients as immunosuppressed. The most frequently implicated germ is Staphylococcus aureus. They can be divided into acute and chronic, or hematogenous and contiguous. We present a case report treated at the Orthopedic Surgery and Traumatology Service (TOC) of the University Hospital Complex of Santiago de Compostela (CHUS) discussing treatment options that are currently considered the most used. After analyzing the data obtained from the review of this case, we could suggest that, in case of chronic tibial osteomyelitis that did not evolve correctly with conservative treatment with antibiotics, A surgical treatment should be performed at two moments. Initially, eradicating the infection with systemic and local antibiotic therapy, aggressive soft tissue and bone debridement, achieve temporal stability of the affected segment. In a second time, to achieve a definitive stability (after eradication infection) by means of using vascularized bone grafts or endomedullary nailing systems in addition to performing a soft tissue coverage preferably with muscular flaps by greater vascularization.
Evidence level: IV.
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