Chronic osteomyelitis of the pelvis.
The aim of this study was to examine the aetiology and response to treatment of a series of patients with pelvic osteomyelitis. Criteria for selection were multiple positive intra-operative cultures and/or a positive radiological diagnosis. Twenty patients met these criteria (age range: 21-78 years, mean = 46). Data was recorded on host status using the Cierny-Mader classification, neurological status, causative organisms; sensitivities were recorded and the treatment and its outcome. Pelvic osteomyelitis was frequently caused by unusual organisms; a high incidence (45%) of neurologically compromised patients was noted. There were important differences in infective organisms, treatment and outcome in the paraplegic and non-paraplegic population. A high mortality and a high incidence of squamous cell carcinoma was observed. Pelvic osteomyelitis should be managed differently to long bone osteomyelitis as far as the antibiotic therapy is concerned, with a greater need for broad spectrum antibiotics in pelvic osteomyelitis. The response to surgical resection was similar to long bone osteomyelitis with a high chance of success with marginal resection in type A hosts and with wide resection in type B hosts.
Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh, United Kingdom. rishi.ramaesh@gmail.com
Rishikesan
R
Ramaesh
Mark S
MS
Gaston
A Hamish R W
AH
Simpson
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D010264:Paraplegia / Q000453:epidemiology; D010384:Pelvic Bones; D016896:Treatment Outcome