Chronic osteomyelitis is a relatively common infection and is often a lifelong disease. Traditionally, osteomyelitis has been treated with 4-6 weeks of parenteral antibiotics after definitive debridement surgery. Antibiotic-impregnated cement beads have also been used as adjuvant therapy for chronic osteomyelitis. However, this time frame of antibiotic treatment has no documented superiority over other time intervals, and there is no evidence that prolonged parenteral antibiotics will penetrate the necrotic bone. There is no solid evidence in the medical literature to support the continuous use of long duration antibiotic treatment for chronic osteomyelitis. A small number of comparative trials on the treatment of chronic osteomyelitis have been published. Also, the type of surgical procedures practiced in the past in treating chronic osteomyelitis and the lack of effective muscle flap application might have contributed to the prolonged antibiotic treatment. And although the surgical approach to the treatment of chronic osteomyelitis has advanced markedly, still the same duration of antibiotic treatment is adopted. In this review we question the continuous and traditional use of long-term antibiotic treatment for chronic osteomyelitis in spite of the advances in surgical treatment using flaps. The medical literature, including studies in animals and humans, was searched for evidence to support the use of short courses of antibiotics. We hope this review will provoke the initiation of animal studies and clinical trials assessing the use of short courses of antibiotics for chronic osteomyelitis.

Burn injuries involving the joints around the lower extremity often lead to debilitating postburn contractures that frequently compromise extremity functions. Treatment of such injuries, especially involving the ankle and foot area, is very challenging. Conservative management has limited efficiency in correcting the deformities, whereas open surgical treatment is often coupled with high complication rates because of poor soft-tissue coverage and poor vascularity around the burnt areas. The use of the Ilizarov fixator has the advantage of tackling these deformities without the need for extensive open surgical procedures, which will minimize complications and recurrences. The authors present a series of three patients, two adults and one pediatric patient, who were treated successfully with minimally invasive surgery and soft-tissue distraction with the Ilizarov apparatus.