Chronic Osteomyelitis Revisited: A Case Report

Abstract

Chronic osteomyelitis treatment is always a challenge to orthopaedic surgeons which requires great dedication and perseverance. We report a successful limb salvage case of a 46-year-old man who suffered from a left tibia chronic osteomyelitis with soft tissue defect. The treatment approach was a thorough wound debridement of devitalized tissues and necrotized bone, commencement of culture-directed antibiotics, reconstruction with vascularized osteomyocutaneous fibula flap, and skeletal stabilization with internal fixation. As compared to below knee amputation, the result we obtained in this case is more promising with regard to mobility and function.

Isolated Tuberculosis of the Wrist: Subtle but Destructive

“…This is nonspecific and can be present in conditions such as pyogenic osteomyelitis, inflammatory arthritis, and malignancy [7]. Sometimes, this condition can be misleading as patients also have bone destruction similar to that which can be found in that particular disease, whereas chronic bone infection should have sequestrum, involucrum, and cloaca in the radiograph six weeks or more following acute osteomyelitis [8]. CT and MRI scans are also nonspecific.…”

Early Physiotherapy as an Adjunct to Surgical Approach in Case of Chronic Tibial Osteomyelitis Treated with Sequestrectomy and an Ilizarov Ring Fixator in a 14-Year-Old Schoolgirl: A Case Report

“…Based on the histopathological observations rather than the length of the infection, osteomyelitis is categorized as acute or chronic. Usually, acute osteomyelitis develops two weeks after bone inflammation and is marked by inflammatory changes in the bone [ 2 ]. While, chronic osteomyelitis (COM) sets six or more weeks after bone infection and is better recognized as a long-term bone infection, marked by a tenacious microorganism formation, the appearance of a dead bone with surrounding infected unhealthy granulation tissue, low-grade inflammation, and discharging sinus [ 2 , 3 ].…”

“…Usually, acute osteomyelitis develops two weeks after bone inflammation and is marked by inflammatory changes in the bone [ 2 ]. While, chronic osteomyelitis (COM) sets six or more weeks after bone infection and is better recognized as a long-term bone infection, marked by a tenacious microorganism formation, the appearance of a dead bone with surrounding infected unhealthy granulation tissue, low-grade inflammation, and discharging sinus [ 2 , 3 ]. It is a significant complication of acute osteomyelitis when the latter is not treated promptly and adequately in nearly 10-30% of cases [ 2 , 4 ].…”

“…While, chronic osteomyelitis (COM) sets six or more weeks after bone infection and is better recognized as a long-term bone infection, marked by a tenacious microorganism formation, the appearance of a dead bone with surrounding infected unhealthy granulation tissue, low-grade inflammation, and discharging sinus [ 2 , 3 ]. It is a significant complication of acute osteomyelitis when the latter is not treated promptly and adequately in nearly 10-30% of cases [ 2 , 4 ]. The pathogenesis includes metaphysis infection, followed by the development of a subperiosteal abscess, discharging sinus, and sequestrum (dead bone).…”

A Novel Implementation of Physiotherapy in a Known Case of Malunited Supracondylar Fracture of the Femur With Osteomyelitis Managed With Ilizarov Fixator

“…Osteomyelitis is visible mainly in those kinds of open fractures that are contaminated grossly and in those sorts of fractures that have undergone the procedure of internal fixation. The percentage of risk of osteomyelitis, which is trauma-induced in long open bone fractures, ranges somewhere between 3% and 50% based on its severity level, with the recurrence rates approximately as high as 20%-30% [ 5 ]. Chronic osteomyelitis usually lasts longer, and the patient is susceptible to repeated attacks [ 6 ].…”