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osteomyelitis; septic nonunion

M A McNally, J Y Ferguson, A C K Lau, M Diefenbeck, M Scarborough, A J Ramsden, B L Atkins
AIMS: Chronic osteomyelitis may recur if dead space management, after excision of infected bone, is inadequate. This study describes the results of a strategy for the management of deep bone infection and evaluates a new antibiotic-loaded biocomposite in the eradication of infection from bone defects. PATIENTS AND METHODS: We report a prospective study of 100 patients with chronic osteomyelitis, in 105 bones. Osteomyelitis followed injury or surgery in 81 patients...
September 2016: Bone & Joint Journal
D Krappinger, R A Lindtner, M Zegg, A Dal Pont, B Huber
OBJECTIVE: Treatment of large dia- and metaphyseal bone defects (> 3 cm) with two surgical interventions with an interval of 4-8 weeks. INDICATIONS: Dia- and metaphyseal bone defects predominantly of the lower extremity. CONTRAINDICATIONS: Intraarticular bone defects, persisting bone infection or osteomyelitis, insufficient soft tissue coverage in the region of the bone defect, osteoporosis. SURGICAL TECHNIQUE: First surgical intervention: thorough bone debridement and soft tissue coverage, implantation of a cement spacer into the bone defect for the induction of a synovial foreign-body membrane, internal or external fixation...
August 2015: Operative Orthopädie und Traumatologie
Jeffrey Moore, Wayne S Berberian, Manuel Lee
BACKGROUND: In the setting of chronic osteomyelitis following fractures about the ankle, reconstruction through bony arthrodesis may be used as a reconstructive alternative to amputation. During these cases, surgeons often avoid using internal fixation in an attempt to avoid reinfection or premature hardware failure. In this retrospective review, we analyzed the outcomes of chronic osteomyelitic patients who had an arthrodesis of the ankle using either internal or external fixation, focusing on salvage rates, infection clearance, union rates, and functional outcomes...
May 2015: Foot & Ankle International
L Mathieu, F Mottier, A Bertani, J Danis, F Rongiéras, F Chauvin
INTRODUCTION: The purpose of this study was to report the experience of the French Army Medical Service in the management of neglected open extremity fractures and related-complications in Chad. HYPOTHESIS: Delayed treatment of open extremity fractures is possible in a low-resource setting. METHODS: An observational prospective study was performed in a French Forward Surgical Team deployed in N'Djamena for six months. RESULTS: Twenty-seven patients, 24 men and three women, mean age 30 years old with an open fracture that was managed more than 24 hours after it occurred were included...
November 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
M Sanders, J A Albright
The technique of extensive wound debridement and secondary use of autogenous cancellous bone chips can be used to salvage both septic nonunions and chronic osteomyelitis. The same technique may also be used to bridge large bony defects of traumatic origin. With time, the cancellous bone becomes completely incorporated and strengthens, allowing full use of the limb. There are few complications with the procedure. Nonunion may develop on occasion and require a closed bone graft once the wound is free of infection and closed...
October 1, 1984: Orthopedics
Abhay Deodas Gahukamble, Andrew McDowell, Virginia Post, Julian Salavarrieta Varela, Edward Thomas James Rochford, Robert Geoff Richards, Sheila Patrick, Thomas Fintan Moriarty
Propionibacterium acnes and coagulase-negative staphylococci (CoNS) are opportunistic pathogens implicated in prosthetic joint and fracture fixation device-related infections. The purpose of this study was to determine whether P. acnes and the CoNS species Staphylococcus lugdunensis, isolated from an "aseptically failed" prosthetic hip joint and a united intramedullary nail-fixed tibial fracture, respectively, could cause osteomyelitis in an established implant-related osteomyelitis model in rabbits in the absence of wear debris from the implant material...
May 2014: Journal of Clinical Microbiology
Rishi Raj Agarwal, Kevin Broder, Anna Kulidjian, Richard Bodor
We report the successful use of an extended lateral gastrocnemius myocutaneous flap for coverage of the midlateral femur using successive delayed elevations. A 62-year-old man underwent wide resection of a liposarcoma of the right anterior thigh with free flap reconstruction and subsequent radiation therapy 10 years before. Four years later, the patient fractured his irradiated femur and was treated with a retrograde intramedullary nail, which subsequently became infected, causing osteomyelitis of the distal femur, septic arthritis of the knee joint, and nonunion of his pathologic fracture...
May 2014: Annals of Plastic Surgery
Giovanni Manzi, Delia Romanò, Laura Moneghini, Carlo L Romanò
BACKGROUND: Osteopetrosis is a rare, inherited, bone disorder, characterized by osteosclerosis, obliteration of the medullary cavity and calcified cartilage. The autosomal dominant form is compatible with a normal life span, although fractures often result from minimal trauma, due to the pathologic nature of bone. Osteomyelitis is common in patients with osteopetrosis because of a reduced resistance to infection, attributed to the lack of marrow vascularity and impairment of white cell function...
2012: BMC Musculoskeletal Disorders
Alan Ng, Esther S Barnes
The management of complications resulting from the open reduction and internal fixation of ankle fractures is discussed in detail. The initial radiographic findings of the most common postsurgical complications of ankle fracture reduction are briefly discussed, namely lateral, medial, and posterior malleolar malunion or nonunion, syndesmotic widening, degenerative changes, and septic arthritis with or without concomitant osteomyelitis. Emphasis is placed on the management of these complications, with a review of the treatment options proposed in the literature, a detailed discussion of the authors' recommendations, and an inclusion of different case presentations...
January 2009: Clinics in Podiatric Medicine and Surgery
Li-ming Fang, Jun-qiang Wang, Jun Zhang, Ji-yuan Zheng, Shu-xi Zhang, Yan Wang
OBJECTIVE: To evaluate the long-term outcomes of surgical treatment of open fracture of talus. METHODS: Sixteen patients with displaced open fractures of the talus, including 3 cases of type 1, 8 of type 2, 2 of type 3A, 2 of type 3B, and 1 of type 3C according to the Gustilo-Anderson classification system, 15 males and 1 female, aged 37.5 (21 - 48), were treated with open reduction and stable internal fixation within 6 - 8 hours after injury, and followed up for 3...
November 6, 2007: Zhonghua Yi Xue za Zhi [Chinese medical journal]
T Bauer, L Lhotellier, P Mamoudy, A Lortat-Jacob
PURPOSE OF THE STUDY: Infection on continuous bone is a specific diagnostic and therapeutic entity. Treatment requires debridement of infected and necrotic soft tissue and bone, dead space management, effective antibiotic therapy in the bone and good skin coverage with well-vascularized tissues. Results of treatment of infection on continuous bone of the lower limb are presented in this series. MATERIAL AND METHODS: This retrospective series included 127 cases of osteomyelitis affecting continuous bone of the lower limb (tibia or femur)...
December 2007: Revue de Chirurgie Orthopédique et Réparatrice de L'appareil Moteur
Tamon Kabata, Hiroyuki Tsuchiya, Keisuke Sakurakichi, Teruhisa Yamashiro, Koji Watanabe, Kasuro Tomita
BACKGROUND: Nonunions of a juxta-articular lesion with bone loss, which represent a challenging therapeutic problem, were treated using external fixation and distraction osteogenesis. METHODS: Seven juxta-articular nonunions (five septic and two aseptic) were treated. The location of the nonunion was the distal femur in four patients, the proximal tibia in one patient, and the distal tibia in two patients. All of them were located within 5 cm from the affected joints...
June 2005: Journal of Trauma
Muharrem Inan, Sinan Karaoglu, Feridun Cilli, C Yildirim Turk, Ahmet Harma
UNLABELLED: Eleven patients with femoral diaphyseal nonunions after intramedullary nailing were treated with cyclic compression and distraction with an external fixator over the nail. We evaluated the limitations of this technique and whether patients having this closed procedure could achieve union without additional operative procedures. Patients with hypertrophic nonunions (n = 4) were treated with gradual compression of the nonunion site. Cyclic compression and distraction was done in patients with oligotrophic (n = 2) or atrophic nonunions (n = 5) to stimulate consolidation...
July 2005: Clinical Orthopaedics and related Research
Eugene Zarutsky, Shannon M Rush, John M Schuberth
The authors retrospectively reviewed their experience with circular wire external fixation in the treatment of salvage ankle arthrodesis during the past 9 years. The results of 43 cases in a difficult patient population are presented with an average follow-up of 27.0 months. Thirty-three patients (80.5%) went on to achieve a solid fusion or stable pseudarthrosis. A minimum of a 4-ring frame construct was applied for an average of 96.1 days. The major complication rate was 51.2%, including 3 below-knee amputations (7...
January 2005: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
M A Owen
The use of a 'hybridised' Ilizarov ring fixator is described in the salvage of a septic nonunion of a comminuted tibial fracture with a large diaphyseal cortical sequestrum in an 11-month-old German shepherd dog. A ring fixator assembly incorporating half pin application was chosen to provide flexibility of fixation placement options in limited bonestock which had previously been subject to conventional Kirschner-Ehmer external fixation. Diaphyseal regeneration was achieved by stimulating bone trophism through the axial loading properties of the Ilizarov fixator and the biological osteoinductive properties of cancellous bone autograft...
March 2000: Journal of Small Animal Practice
C T Wang, S C Huang
Bone and joint infections in childhood can result in various sequelae including deformity and limb length discrepancy (LLD). Management of these sequelae is difficult and must be individualized. In this study, we retrospectively examined the efficacy of treatment with Ilizarov techniques in 30 patients suffering from sequelae of bone and joint infections in childhood, treated from 1989 to 1994. These cases comprised 17 hip infections, two septic shoulders, and 11 cases of osteomyelitis (4 femurs, 5 tibiae, 1 humerus, and 1 forearm)...
March 1999: Journal of the Formosan Medical Association, Taiwan Yi Zhi
M M Tomaino, C V Bowen
We examined unsatisfactory outcome after microvascular reconstruction of 34 injured lower extremities at the Toronto Hospital between 1987 and 1992. Our purpose was to examine those factors that contributed to poor outcome in order to improve decislon making when treating the traumatized lower extremity. For the purpose of this review, poor outcome was defined by either secondary elective amputation or patient dissatisfaction. Patients were divided according to preoperative problem into one of three groups: osteo/cutaneous deficit (group 1), septic nonunion (group 2), and osteomyelitis (group 3)...
July 1998: American Journal of Orthopedics
Y Allieu, M Chammas, M L Hixson
The indications for external fixation in the treatment of hand infections are limited; however, external fixation, which is considered to be a salvage procedure, has many advantages in selected cases, such as severely contaminated open injuries, septic nonunions, and advanced septic arthritis with segmental bone loss and skin defects. External fixation can be used in different ways and must be included in a planned program for the treatment of bone infection.
November 1993: Hand Clinics
G K Dendrinos, K Katsioulas, P N Krallis, E Lyritsis, G Papagiannopoulos
Twenty two patients aged 18 to 47 years were treated for 24 infected bone defects and nonunions (6 femora and 16 tibiae) by radical resection of the necrotic bone and distraction osteogenesis techniques to regenerate the excised bone. Nonunion, infection, limb shortening, deformity, and osteoporosis were all addressed simultaneously. All patients underwent either bifocal or trifocal internal lengthening by bone transport technique of sliding a bone fragment, producing distraction osteogenesis behind it until the defect was bridged...
1995: Revue de Chirurgie Orthopédique et Réparatrice de L'appareil Moteur
F Lechner, R Ascherl, W Uraus
In 319 patients suffering from septic and noninfected pseudarthroses, bone consolidation has been achieved in 93.6% by a cancellous bone graft plus a semi-invasive method of electrostimulation of nonunion using low frequency A.C. potentials, i.e., the electrodynamic procedure. By inductively coupled electromagnetic fields, the potentials are produced in inductable implants. There are no contraindications for the procedure and no side effects.
November 1981: Clinical Orthopaedics and related Research
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