[Chronic osteomyelitis: one-step treatment].
OBJECTIVE
Chronic osteomyelitis is a surgical disease that require significant dedication from surgeons to eradicate. Osteomyelitis can result from a variety of etiologies but most often is a consequence of trauma (open fractures) to a long bone. This type includes osteomyelitis secondary to a contiguous focus of infection (after trauma and its surgical treatment: osteosynthesis). Here we are reporting one case of post-traumatic chronic osteomyelitis of the humerus.


METHODS
A 34-years-old man presented with a post-traumatic chronic osteomyelitis due to an open fractur of the diaphysis humerus. We proposed a one-step surgical treatment, including fistulectomy, sequestrectomy, opening of the proximal and distal intramedullary canal. Antimicrobial therapy should be followed by close observation and treatment with appropriate antibiotics.


RESULTS
A clinical control at 30 days from the intervention revealed that: no secretion; negative cultured exam; second-intention healing of the skin.


CONCLUSIONS
Treatment requires isolation of the pathogens, significant debridement for removal of all infective and necrotic material, both of bone origin and soft-tissue one. Is is necessary not to close the foci: in this way we leave an external drainage, which is able to provide a tissues sterilization by secretion drainage and by the effects of the systemic antimicrobial therapy. Our results indicate that this long-term problem can be solved by a one-stage procedure that provide spontaneous second- healing of the skin defects, excluding the bony and soft tissue reconstruction.
Rizzello
G
G
Policlinico Universitario Campus Bio-Medico Roma, Italia. g.rizzello@unicampus.it
Meloni
M C
MC
Ippolito
M
M
Marinozzi
A
A
Barnaba
S A
SA
Denaro
V
V
D000328:Adult; D002908:Chronic Disease; D006801:Humans; D006811:Humerus; D008297:Male; D010019:Osteomyelitis / Q000601:surgery*