[Osteomyelitis of the carpus and metacarpus].
OBJECTIVE
Because of the low prevalence, there is poor evidence on the effective management of bone and joint infections of the carpus and metacarpus. We therefore studied the outcomes of patients undergoing surgical treatment at our department.


METHODS
We conducted a retrospective study on all patients operated on because of osteomyelitis of the carpus and metacarpus between January 1998 and June 2004. Main study endpoint were the infection control rate at end of treatment and at time of follow-up.


RESULTS
Of eleven subjects (nine men, two women) with a median age of 43 years (range, 19 to 79 years) serial débridement with temporary wound closure and surgical fixation proved successful in ten cases. We identified causative pathogens in ten cases (S. aureus: n = 3, P. aeruginosa: n = 3, mixed: n = 4) by intraoperative biopsy. Eight subjects received local or free tissue flaps. A 73 year old man died in hospital. Follow-up information was available for eight patients after a median of 19.5 months (range: 3 to 61 months). Seven of them did not show signs of recurrent infection.


CONCLUSIONS
Adhering to accepted standards of treating osteomyelitis, satisfactory control rates in carpal and metacarpal infection can be achieved while salvaging the hand.
Eisenschenk
A
A
Unfallkrankenhaus Berlin, Abteilung für Hand-, Replantations- und Mikrochirurgie.
Bauwens
K
K
Böttcher
R
R
Stengel
D
D
D000328:Adult; D000368:Aged; D002348:Carpal Bones / Q000473:pathology / Q000601:surgery*; D003646:Debridement; D005260:Female; D005593:Fracture Fixation, Internal; D005839:Gentamicins / Q000008:administration & dosage; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000473:pathology / Q000601:surgery*; D008768:Methylmethacrylates / Q000008:administration & dosage; D008875:Middle Aged; D009779:Occlusive Dressings; D010019:Osteomyelitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011552:Pseudomonas Infections / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013203:Staphylococcal Infections / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps
D005839:Gentamicins; D008768:Methylmethacrylates; C030159:gentamicin-polymethylmethacrylate bead