Hemidiaphysectomy to control chronic osteomyelitis.
A retained Küntscher nail in the left femur of a 34-year-old man was complicating the course of chronic, unremitting osteomyelitis. The nail was bent and could not be removed by routine methods. A hemidiaphysectomy of the femur allowed easy removal of the nail and radical curettage of the chronically infected intramedullary granulation tissue. The portion of the diaphysis removed at osteotomy was replaced without internal fixation. Postoperative external fixation was considered unnecessary because of the bulk of the femoral diaphysis secondary to the chronic sclerosis of osteomyelitis. Roentgenograms taken seven months after operation showed healing of the femur and no evidence of sequestration of the bone fragment. At 23 months' follow-up, the patient has no pain, no drainage, and no limitation of activities. Long-term follow-up is planned.
D000328:Adult; D001858:Bone Nails / Q000009:adverse effects; D002908:Chronic Disease; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur; D005547:Foreign Bodies / Q000150:complications*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000209:etiology* / Q000601:surgery