Recent Advances in Treatment of Osteomyelitis Following Fractures of the Long Bones

Rowe, Carter R.; Sakellarides, Harilaos T.

doi:10.1016/s0039-6109(16)36531-8

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…This contradicts the results of the study by Grigorian et al [ 22 ]. However, earlier studies showed results similar to ours [ 23 , 24 ]. More prospective studies are needed to assess the relationship between the type of long bone fractures and acute or chronic osteomyelitis.…”

Section: Discussionsupporting

confidence: 90%

Risk Factors for Postoperative Osteomyelitis among Patients after Bone Fracture: A Matched Case–Control Study

Slyamova

Gusmanov

Batpenov³

et al. 2022

JCM

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The healthcare burden of osteomyelitis is increasing. Postoperative and posttraumatic osteomyelitis account for 80% of all cases of osteomyelitis. The aim of this study was to find risk factors for postoperative osteomyelitis in Kazakhstan. We included 245 patients admitted to the National Scientific Center of Traumatology and Orthopedics from 2018 to 2020. Cases were matched with controls in a 1:4 ratio. Exact matching was performed by gender, ICD-10, and ICD-9 codes. The main variables included socio-demographics, diagnosis at admission, characteristics of fractures, comorbidities, complications, hospitalization milestones, and osteomyelitis characteristics. Descriptive analyses, along with bivariate analysis and multivariate conditional logistic regression, were performed. Open fracture (adjOR = 6.25; 95%CI 1.64–23.79), the presence of complications of initial fracture (adjOR = 3.46, 95%CI 1.13–10.56), comminuted fracture form (adjOR = 1.87; 95%CI 0.73–4.75), a positive history of diabetes or blood glucose >7 g/L (adjOR = 4.25; 95%CI 1.26–14.3), incision or wound length of more than 10 cm (adjOR = 6.53; 95%CI 1.1–38.6), additional implanted medical item (adjOR = 1.23; 95% CI 1.1–1.47), and unemployment or being retired (adjOR = 4.21; 95%CI 1.74–10.18) were found to be significant predictors of postoperative osteomyelitis. Almost all our findings are concordant with previous studies, except for the type of fracture. Different authors report conflicting results on the latter potential risk factor. Therefore, prospective studies on this issue are required.

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Section: Discussionsupporting

confidence: 90%

Risk Factors for Postoperative Osteomyelitis among Patients after Bone Fracture: A Matched Case–Control Study

Slyamova

Gusmanov

Batpenov³

et al. 2022

JCM

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“…This association has widely been believed to be true by practicing surgeons since the 1960s, even though the evidence has been poor. 18,19 The pathogenesis of osteomyelitis is likely multifactorial but remains poorly understood. In trauma, it is believed to involve direct inoculation of microorganisms into bone made possible by breakage in skin and/or soft tissue.…”

Section: Discussionmentioning

confidence: 99%

No increased risk of acute osteomyelitis associated with closed or open long bone shaft fracture

Grigorian

Schubl

Scolaro

et al. 2019

Journal of Clinical Orthopaedics and Trauma

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Objectives: Osteomyelitis of the long bones can result from hematogenous spread, direct inoculation or from a contiguous focus of infection. The association of osteomyelitis after long bone fractures has widely been believed to be true by practicing surgeons since the 1950s, even though the evidence has been poor. We hypothesized that long bone shaft fracture and major bone surgery are independent risk factors for osteomyelitis in adult trauma patients. Methods: The National Trauma Data Bank (NTDB) was queried between 2007 and 2015 for patients 18 years of age presenting after trauma. Patients with long bone shaft fractures (femur, tibia/fibula, humerus) were identified and rate of acute osteomyelitis was calculated. Univariable logistic regression was performed. A multivariable logistic regression was performed to identify risk factors for development of acute osteomyelitis. Results: From 5,494,609 patients, 358,406 were identified to have long bone shaft fractures (6.5%) with the majority being tibia/fibula (44.3%). The osteomyelitis rate in long bone shaft fractures was 0.05%. Independent risk factors for osteomyelitis included major humerus surgery and major tibia/fibula surgery. The strongest risk factor was non-pseudomonas bacteremia. Long bone shaft fractures were not found to be an independent risk factor for osteomyelitis (p > 0.05). Conclusions: Long bone shaft fractures are not independently associated with increased risk for osteomyelitis. Major extremity surgery on the humerus and tibia/fibula, but not femur, are independent risk factors for osteomyelitis. However, the strongest risk factor is non-pseudomonas bacteremia.

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“…A recent study of fracture epidemiology has shown that calcaneal fractures account for 1.2% of all fractures 4 and studies of calcaneal fractures have shown that avulsion fractures of the calcaneal tuberosity comprise only 1.3% to 2.7% of calcaneal fractures. 4,12,17 It is therefore understandable that little has been written about these fractures.…”

Section: Introductionmentioning

confidence: 99%

Avulsion Fracture of the Calcaneal Tuberosity: A Case Report and Literature Review

2008

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Recent Advances in Treatment of Osteomyelitis Following Fractures of the Long Bones

Cited by 8 publications

References 6 publications

Risk Factors for Postoperative Osteomyelitis among Patients after Bone Fracture: A Matched Case–Control Study

Risk Factors for Postoperative Osteomyelitis among Patients after Bone Fracture: A Matched Case–Control Study

No increased risk of acute osteomyelitis associated with closed or open long bone shaft fracture

Avulsion Fracture of the Calcaneal Tuberosity: A Case Report and Literature Review

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