title: [Rib span-plasty in sequestered osteomyelitis of the femoral diaphysis].
abstract: A case is reported of a 6-year-old boy with acute pyogenic osteomyelitis. A delay in making the diagnosis or inadequate early treatment led to chronic osteomyelitis. A delay in making a diagnosis is the most important factor in the prognosis of acute osteomyelitis. Sophisticated techniques are only indicated to detect and confirm the nature of the lesion, but they should not delay identification of the causative organisms. In our case, the diagnosis was delayed, and there was complete sequestration of the femur shaft as a result of insufficient early treatment. After diagnosis, the initial step was surgical debridement. After complete necrotomy, continuous irrigation with suction drainage was begun. To fill the defect and accelerate bone reconstruction, we performed an autogenous graft taking the 8th rib and splitting it into nine fragments. After identification of Pseudomonas aeruginosa as the causative organism, parenteral antibiotic therapy was begun and maintained. Nine weeks after admission, the boy was able to leave the hospital. Ten weeks later he was examined in the outpatient clinic and was walking and running quite normally. To date, there has been no recurrence of the infection.
authors.forename: M
authors.initials: M
authors.lastname: Pip
authors.forename: H K
authors.initials: HK
authors.lastname: Kaufner
mesh_terms: D016025:Bone Transplantation; D002648:Child; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D005592:Fracture Fixation; D005598:Fractures, Spontaneous / Q000601:surgery*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000601:surgery*; D012272:Ribs / Q000637:transplantation
vernacular_title: Rippenspanplastik bei sequestrierender Osteomyelitis der Femurdiaphyse.