title: Posttraumatic tibial osteomyelitis: a comparison of three treatment approaches.
abstract: The treatment of 25 tibias in 25 patients with posttraumatic chronic osteomyelitis was reviewed. The approaches to soft tissue management fell into three groups: 1) muscle flap coverage; 2) primary closure with suction irrigation; and 3) open cancellous bone grafting. Treatment success was judged by the presence or absence of drainage and the local signs or symptoms of infection, and by the status of the tibial nonunion. Overall, 19 of 25 tibias (76%) had successful treatment. We found flap coverage to have a higher success rate (80%) than either primary closure with suction irrigation (45.5%) or open cancellous bone grafting (40%). These results further attest to the refractory nature of chronic osteomyelitis.
authors.affiliation: Department of Orthopaedics, Hospital for Joint Diseases, Orthopaedic Institute, New York, NY 10003.
authors.forename: K J
authors.initials: KJ
authors.lastname: Koval
authors.forename: S E
authors.initials: SE
authors.lastname: Meadows
authors.forename: H
authors.initials: H
authors.lastname: Rosen
authors.forename: L
authors.initials: L
authors.lastname: Silver
authors.forename: J D
authors.initials: JD
authors.lastname: Zuckerman
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000601:surgery; D002908:Chronic Disease; D003646:Debridement; D005260:Female; D005592:Fracture Fixation; D005596:Fractures, Closed / Q000150:complications / Q000601:surgery; D005597:Fractures, Open / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013396:Suction; D013524:Surgical Flaps; D013977:Tibia / Q000601:surgery*; D013978:Tibial Fractures / Q000150:complications* / Q000601:surgery