Calcaneal osteomyelitis due to fistulization of an ulcerated rheumatoid nodule

Alcaraz, Patrice; Aubran, C.; Jaoua, Samir; Roudier, Chantal; Mattei, Jean‐Pierre; Announ, Nadia; Chagnaud, Christophe; Roudier, Jean; Guis, Sandrine

doi:10.1016/j.jbspin.2005.01.006

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…There is currently an insufficiency of literature associated with calcaneal osteomyelitis. Limited references have reported that calcaneal osteomyelitis contributes only a small part of all reported bone infections (10). Although ORIF via an extensible lateral L-shaped approach is recognized as a gold standard treatment for calcaneus fracture, this surgical protocol may also induce the complication of wound infection, with an incidence of 2-15%.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of osteomyelitis has accounted for 1-4% of closed fracture complications (11). Calcaneal osteomyelitis is likely to result in partial or total calcanectomy, or more severely, amputation (10). Therefore, due to its limb-threatening nature, it is important to understand the epidemiology and clinical features of osteomyelitis following surgery for calcaneal fracture.…”

Section: Discussionmentioning

confidence: 99%

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The epidemiology and clinical features of calcaneus osteomyelitis following calcaneus fracture: a retrospective study of 127 cases

Huang¹,

Guo²,

Zhu³

2021

Ann Palliat Med

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Background: To analyze the epidemiology and features of calcaneus osteomyelitis following open reduction and internal fixation (ORIF) after closed calcaneus fracture.Methods: We retrospectively analyzed 127 cases who were diagnosed with calcaneal osteomyelitis following ORIF via the extended lateral "L-shaped" approach after closed calcaneus fracture between March 2016 and August 2019 in our hospital. We analyzed participant demographics including gender, age, body mass index (BMI), trauma mechanism, Sanders classification, co-morbidity, time between initial injury and surgery, operating time, soft tissue stripping tools, tourniquet pressure, bone grafting option, internal fixation option, presence of bleeding after tourniquet deflation, and drainage option.Results: The majority of cases (n=127) were male (4.5 times more than female gender), at a ratio of 4.47:1.Falling from height was the main trauma mechanism (79.53%), followed by traffic accident (14.17%), and jumping (6.3%). A total of 51 cases (40.16%) were left-side fractures, and 76 (59.84%) were right-sided.According to the Sanders classification, 12 cases were type II (9.45%), 61 cases were type III (48.03%), and 54 cases were type IV (42.52%). There were 25 participants with the co-morbidity of type 2 diabetes mellitus (19.69%), 7 with hypertension (5.51%), and 1 case each of psoriasis and sicca syndrome (0.8%). The mean time to surgery was 4.7 days (4-9 days), and 123 participants (96.85%) were treated within 7 days. The mean operating time was 102.1 min (75-135 min). Forty-four participants (34.65%) received the conventional scalpel and 83 participants (65.35%) the electric scalpel during soft tissue stripping intraoperatively. The mean tourniquet pressure was 432.3 mmHg (350-550 mmHg). Autologous bone grafting was observed in 6 cases (4.72%), allograft bone grafting in 11 cases (8.67%), and OsteoSet grafting in 7 cases (5.51%).A locking plate was used in 114 cases (89.76) while anatomical plate in 13 cases (10.24%). A total of 27 participants (21.26%) bled after tourniquet deflation. Drainage tubes were applied in 30 participants (23.62%) while rubber drainage strips in 5 participants (3.94%).Conclusions: Young males dominated the calcaneus osteomyelitis following traumatic calcaneus fracture cohort in this study. A fall from height was the most frequent trauma mechanism. The presence of severe calcaneus fracture, Sanders type III (48.03%) and type IV (42.52%), were the common fracture types in this population group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The epidemiology and clinical features of calcaneus osteomyelitis following calcaneus fracture: a retrospective study of 127 cases

Huang¹,

Guo²,

Zhu³

2021

Ann Palliat Med

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The plausible association of MTHFR and ADORA2A polymorphisms with nodules in rheumatoid arthritis patients treated with methotrexate

Soukup

Doseděl

Nekvindová

et al. 2017

Pharmacogenetics and Genomics

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Clinical characteristics, treatment and efficacy of calcaneal osteomyelitis: a systematic review with synthesis analysis of 1118 reported cases

Jiang,

Chen,

Liu

et al. 2024

International Journal of Surgery

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Background: Calcaneal osteomyelitis (CO) still poses great challenges to orthopaedic surgeons due to unique anatomic and functional features of the calcaneus. This study summarized the current data regarding clinical characteristics, treatment and efficacy of CO, based on an analysis of literature-reported cases. Materials and Methods: We searched the PubMed, Embase, and Cochrane Library databases to find English and Chinese studies reporting on CO patients between 2000 and 2021, with available data for synthesis analysis. The quality of the included studies was evaluated by the National Institutes of Health (NIH) assessment scale. Effective data were extracted and pooled for analysis. Results: Altogether 198 studies involving 1118 patients were included, with a male-to-female ratio of 2.3 (724 males and 310 females). The median age at CO diagnosis was 46 years, with a median symptom duration of 3 months. Injury-related infections (524 cases) and diabetic foot infections (336 cases) were the two most common causes, with ulcer (468 cases) and wound sinus or exudation (209 cases) being the predominant symptoms. The overall positive culture rate was 80.2%, with polymicrobial infections accounting for 18.1%. Staphylococcus aureus was the most frequently detected pathogen (42.7%), with fungal-related infections isolated in 17 cases. Although most patients received surgical interventions (96.9%), the recurrence rate was 20.1%. The incidence of infection relapse following partial calcanectomy, total calcanectomy, debridement with implantation of local antibiotics, and debridement with or without flap or skin coverage were 31.7%, 45.0%, 16.8%, and 15.1%, respectively. The overall incidence of limb amputation was 12.4%, with all-cause and CO-related mortalities of 2.8% and 0.2%, separately. Conclusions: CO shared similar characteristics with extremity chronic osteomyelitis, primarily affecting young males, with trauma and diabetic foot as the leading causes and Staphylococcus aureus as the most frequently detected pathogen. Despite surgery being the primary treatment modality, clinical outcomes remained unsatisfactory, marked by high rates of infection recurrence and limb amputation.

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Calcaneal osteomyelitis due to fistulization of an ulcerated rheumatoid nodule

Cited by 4 publications

References 11 publications

The epidemiology and clinical features of calcaneus osteomyelitis following calcaneus fracture: a retrospective study of 127 cases

The epidemiology and clinical features of calcaneus osteomyelitis following calcaneus fracture: a retrospective study of 127 cases

The plausible association of MTHFR and ADORA2A polymorphisms with nodules in rheumatoid arthritis patients treated with methotrexate

Clinical characteristics, treatment and efficacy of calcaneal osteomyelitis: a systematic review with synthesis analysis of 1118 reported cases

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