title: [Postoperative implant-associated osteomyelitis of the shoulder: Hardware-retaining revision concept using temporary drainage].
abstract: BACKGROUND
  Posttraumatic and postoperative osteomyelitis (PPO) is a subgroup of bone infections with increasing importance. However, to date no standardized reoperation concept exists particularly for patients with PPO of the shoulder region. Therefore the purpose of this study was to evaluate a revision concept including débridement, irrigation, and insertion of temporary drainage with hardware retention until healing.
  
  
  METHODS
  A total of 31 patients with PPO were included with a proximal humerus fracture (n = 14), clavicle fracture (n = 10), or AC-joint separation (n = 7). In all, 27 of these patients could be followed for > 1 year.
  
  
  RESULTS
  Hardware retention until fracture or ligament healing could be achieved in > 83%. Six patients required follow-up débridement due to recurrent infections, but then were unremarkable. Clinical outcome showed excellent Constant scores (91.6 ± 2.8).
  
  
  CONCLUSIONS
  A cost-efficient, simple, and successful revision concept for patients with PPO of the shoulder region is described.
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, BG Unfallklinik Ludwigshafen, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schnetzke
authors.forename: S
authors.initials: S
authors.lastname: Aytac
authors.forename: P
authors.initials: P
authors.lastname: Herrmann
authors.forename: C
authors.initials: C
authors.lastname: Wölfl
authors.forename: P A
authors.initials: PA
authors.lastname: Grützner
authors.forename: V
authors.initials: V
authors.lastname: Heppert
authors.forename: T
authors.initials: T
authors.lastname: Guehring
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D003646:Debridement / Q000379:methods; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D012086:Reoperation / Q000379:methods; D012785:Shoulder Joint / Q000601:surgery*; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome