title: [One hundred years of orthopedics in the Netherlands. IX. The treatment of chronic osteomyelitis].
abstract: Chronic osteomyelitis is characterized by cicatrization of the focus of infection with deteriorating vascularization, which makes the disease increasingly difficult to treat. The treatment in chronic osteomyelitis consists primarily in surgical debridement of the scarified focus of infection; stabilization with external fixation allows better treatment. Following debridement, local antibiotic treatment is possible with gentamicin containing cement beads, if necessary combined with systemic antibiotic treatment. If the infection heals well, a reconstruction may, if necessary, be carried out: bone defects frequently necessitate bone transplantation, bone segment shifting (Ilizarov method) or free muscle flap grafts. In the future, resistant bacteria will make healing harder. There will be more possibility to use resorbable antibiotic vehicles and bone-replacing biomaterials.
authors.affiliation: Academisch Ziekenhuis, afd. Orthopedie, Maastricht.
authors.forename: G H
authors.initials: GH
authors.lastname: Walenkamp
authors.forename: P M
authors.initials: PM
authors.lastname: van Roermund
authors.forename: J R
authors.initials: JR
authors.lastname: van Horn
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods; D002908:Chronic Disease; D003646:Debridement / Q000379:methods; D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D009426:Netherlands; D009985:Orthopedics / Q000266:history; D010019:Osteomyelitis / Q000266:history / Q000628:therapy*; D012074:Remission Induction
vernacular_title: Honderd jaar orthopedie in Nederland. IX. De behandeling van chronische osteomyelitis.