title: Novel technique for medullary canal débridement in tibia and femur osteomyelitis.
abstract: Intramedullary infection is a challenging problem and treatment usually includes removal of infected hardware and reaming of the medullary canal. We describe a new technique for canal débridement and evaluate its infection control rate in treating osteomyelitis of the tibia and femur. We retrospectively reviewed 11 patients with posttraumatic osteomyelitis of the tibia (n = 8) or femur (n = 3). Surgery included débridement, implant removal, and reaming of the medullary canal with a new device that allows reaming under simultaneous irrigation and aspiration. At a minimum followup time of 6 months (mean, 13 months; range, 6-23 months), we observed no recurrence of infection. Complications included one partial loss of a flap, one refracture of a tibia after an automobile versus pedestrian accident, and external fixator pin tract infections in one patient. These preliminary data suggest the new reaming device may be a useful adjunct for débriding intramedullary infections of the tibia and femur.
authors.affiliation: Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, LAC + USC Medical Center, Los Angeles, CA 90033, USA. zalavras@usc.edu
authors.forename: Charalampos G
authors.initials: CG
authors.lastname: Zalavras
authors.forename: Anshuman
authors.initials: A
authors.lastname: Singh
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Patzakis
mesh_terms: D000328:Adult; D003646:Debridement / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000382:microbiology / Q000601:surgery; D005269:Femur / Q000382:microbiology*; D005597:Fractures, Open / Q000150:complications / Q000382:microbiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery*; D013977:Tibia / Q000382:microbiology*; D013978:Tibial Fractures / Q000150:complications / Q000382:microbiology / Q000601:surgery