Long-term results of multiple-stage treatment for posttraumatic osteomyelitis of the tibia.
J Trauma
; 56(3): 633-42, 2004 Mar.
Article
em En
| MEDLINE
| ID: mdl-15128137
ABSTRACT
BACKGROUND:
The treatment of posttraumatic osteomyelitis of the tibia requires meticulous debridement and adequate soft tissue coverage. At our institution, we perform a staged procedure consisting of surgical debridement followed by muscle coverage. If necessary, implantation of a cancellous iliac bone graft was always performed as a three-stage treatment.METHODS:
We performed a retrospective analysis of 47 patients treated for posttraumatic osteomyelitis of the tibia between 1987 and 1998.RESULTS:
Twenty-two patients originally had a Gustilo grade III fracture, 21 patients had a Gustilo grade I or II or closed fracture, the Gustilo grade was not known for 2 patients, and 2 patients had no fracture. Using the Cierny-Mader classification, most patients had a localized osteomyelitis. To cover the debrided area, 20 pedicled muscle transfers and 28 microvascular free flaps were used; one patient had two localizations of osteomyelitis (both proximal and distal) and received two muscle flaps. Flap failure was 8% and was successfully treated by additional flap coverage in two cases; one was closed by a split skin graft and one was closed by secundum. Twenty-six patients received a cancellous bone graft. During an average follow-up of 94 months, 9% had a recurrence of osteomyelitis for which additional surgical interventions were necessary. Finally, all the infections were eventually cured.CONCLUSION:
Our staged surgery proved to be an excellent method of treating osteomyelitis after open or closed fractures of the tibia.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteomielite
/
Infecções por Pseudomonas
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Infecções Estafilocócicas
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Retalhos Cirúrgicos
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Tíbia
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Fraturas da Tíbia
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Transplante Ósseo
/
Desbridamento
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Trauma
Ano de publicação:
2004
Tipo de documento:
Article