title: Closed double-lumen suction irrigation in the management of chronic diaphyseal osteomyelitis: long-term follow-up.
abstract: Between November 1994 and June 1999, 35 patients referred to our Problem Fracture Service with chronic diaphyseal osteomyelitis were treated using a closed double-lumen suction irrigation system after reaming and arthroscopic debridement of the intramedullary canal. This is a modified system based on that of Lautenbach. Between June and July 2007 the patients were reviewed by postal questionnaire and telephone and from the case notes. At a mean follow-up of 101 months (2 to 150), 26 had no evidence of recurrence and four had died from unrelated causes with no evidence of recurrent infection. One had been lost to follow-up at two months and was therefore excluded. Four had persisting problems with sinus discharge and one had his limb amputated for recurrent metaplastic change. Our results represent a clearance of infection of 85.3% (29 of 34), with recurrence in 11.8% (4 of 34). They are comparable to the results of the Papineau and Belfast techniques, but with considerably less surgical insult to the patient.
authors.affiliation: Robert Jones and Agnes Hunt Orthopaedic Hospital, Hospital NHS Trust, Oswestry, Shropshire SY10 7AG, UK. ben_caesar@hotmail.com
authors.forename: B C
authors.initials: BC
authors.lastname: Caesar
authors.forename: R L
authors.initials: RL
authors.lastname: Morgan-Jones
authors.forename: R E
authors.initials: RE
authors.lastname: Warren
authors.forename: R H
authors.initials: RH
authors.lastname: Wade
authors.forename: P J
authors.initials: PJ
authors.lastname: Roberts
authors.forename: J B
authors.initials: JB
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002908:Chronic Disease; D003646:Debridement / Q000379:methods*; D018483:Diaphyses / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery* / Q000628:therapy; D011446:Prospective Studies; D013396:Suction / Q000295:instrumentation / Q000379:methods; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents