Functional outcome in patients treated for chronic posttraumatic osteomyelitis.
BACKGROUND
Management of chronic posttraumatic osteomyelitis remains an important challenge in orthopaedics. In this investigation, 43 patients at a large university hospital were retrospectively identified who had been diagnosed with chronic osteomyelitis at 44 sites.


METHODS
Diagnosis was based on the patient's history and physical examination, laboratory values, radiological evaluation, and intraoperative specimens. Patients' charts were reviewed and follow-up was obtained on 33 patients in whom Short Musculoskeletal Functional Assessment (SMFA) questionnaires were obtained.


RESULTS
The mean follow-up of the cohort was 21.1 months (range, 10 to 54 months). Sites involved included: tibia (55%) and femur (36%), with the remainder involving the pelvis, radius/ulna, and calcaneus. Blood, bone, or wound aspirate cultures were positive in 85%, most commonly for Staphylococcus aureus. 84% of the patients in this investigation were completely cured after a single surgical intervention, removal of hardware and a course of intravenous antibiotics. Three patients required additional surgical intervention and two remained infected. Ultimately, the cohort reached a cure rate of 94%. SMFA data revealed that patients had a dysfunction score of 53.8 and bother index of 51.5, with 50 being the normal for the general population.


CONCLUSIONS
The patients in this cohort functioned at a level less than one standard deviation below the general population. These results suggest that patients with chronic posttraumatic osteomyelitis do not function significantly below that of the normal population following eradication of their infections.
Egol
Kenneth A
KA
Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, USA. kenneth.egol@nyumc.org
Singh
Jaspal R
JR
Nwosu
Uzoma
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003646:Debridement; D004185:Disability Evaluation; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D010027:Osteotomy; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents