title: [Postoperative osteitis of the pubis: diagnosis, treatment and results].
abstract: OBJECTIVE
  Osteomyelitis of the pubis is a possible complication of urological and gynaecological surgery. This article reviews this disease which is still a source of controversy.
  
  
  METHODS
  Between 1984 and 1997, five patients with osteomyelitis of the pubis, following complementary investigations, underwent resection of the symphysis pubis with histological and bacteriological examination, combined with antibiotic therapy. The follow-up was 1.5 months to 4 years.
  
  
  RESULTS
  The time to onset of first symptoms was 2 weeks to 5 years. Pain initially presented inflammatory features during the early postoperative period and subsequently became mechanical as the disease became chronic, with intermittent acute episodes in 3 cases. Radiation of the pain and the abnormalities observed on imaging were predominantly unilateral in all patients. Fever and laboratory signs of inflammation were inconstant. Bacteria were identified in 4 cases in the absence of antibiotics and lesions of chronic osteomyelitis were observed in every case. Antibiotics were administered by intravenous injection for 3 to 7 weeks, then orally for 1.5 to 3 months. Good functional and infectious results were obtained in 4 patients, while the remaining patient presented posterior instability.
  
  
  CONCLUSIONS
  Postoperative pubic osteomyelitis is an infectious disease. Acute osteomyelitis, which can be treated by antibiotics in the absence of a collection and bone sequestrum, is distinguished from chronic osteomyelitis, in which every effort must be made to identify the bacteria responsible. Infected tissues must be widely excised in combination with prolonged antibiotic therapy. Posterior instability is the main complication.
authors.affiliation: Hôpital de la Fondation Croix Saint Simon, Paris, France. calmeras@yahoo.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Almeras
authors.forename: Faouzi
authors.initials: F
authors.lastname: Madi
authors.forename: Nicole
authors.initials: N
authors.lastname: Desplaces
authors.forename: Patrick
authors.initials: P
authors.lastname: Mamoudy
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011183:Postoperative Complications / Q000175:diagnosis*; D011630:Pubic Bone; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents