title: Calcium sulphate delivery system with tobramycin for the treatment of chronic calcaneal osteomyelitis.
abstract: The case of a 24-year-old woman with Pseudomonas aeruginosa and Proteus mirabilis chronic calcaneal osteomyelitis is presented. Extensive debridement of the necrotic bone and application of tobramycin-loaded polymethylmethacrylate beads was performed and ciprofloxacin was given post-operatively. Three months later, laboratory tests, including complete blood cell count, erythrocyte sedimentation rate and C-reactive protein, were normal. At this time, extensive surgical debridement and filling of the osseous defect with autologous iliac cancellous bone graft and tobramycin-impregnated calcium sulphate pellets and paste were performed. Oral ciprofloxacin was administered for 3 months after surgery. At the latest follow-up, 2 years later, the patient had full weight-bearing function; there was no recurrence of the infection, and complete incorporation of the autologous bone and calcium sulphate graft with the host bone was observed. This case demonstrates that two-stage surgical treatment with extensive debridement and tobramycin-impregnated calcium sulphate was effective in treating chronic calcaneal osteomyelitis.
authors.affiliation: First Department of Orthopaedics, Athens University Medical School, Attikon University Hospital, Athens, Greece. pjp@hol.gr
authors.forename: P J
authors.initials: PJ
authors.lastname: Papagelopoulos
authors.forename: A F
authors.initials: AF
authors.lastname: Mavrogenis
authors.forename: S
authors.initials: S
authors.lastname: Tsiodras
authors.forename: C
authors.initials: C
authors.lastname: Vlastou
authors.forename: H
authors.initials: H
authors.lastname: Giamarellou
authors.forename: P N
authors.initials: PN
authors.lastname: Soucacos
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002133:Calcium Sulfate / Q000008:administration & dosage*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011513:Proteus mirabilis / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D014031:Tobramycin / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014031:Tobramycin; D002133:Calcium Sulfate