title: Two stage reconstruction of septic non-union of the humerus with the use of circular external fixation.
abstract: Achieving quiescence in chronic osteomyelitis remains challenging. Wide resection of all infected and necrotic tissues improves the chances of achieving remission of the disease. Extensive debridement however decreases the already compromised bone stock that increases the complexity of reconstruction. We report on the outcome of eight patients with Cierny and Mader stage IV chronic osteomyelitis of the humerus who underwent debridement followed by bone graft and circular fixator application as a second stage procedure. Resolution of infection and humeral shaft union was achieved in all patients. Our study finds that two-stage reconstruction of stage IV chronic osteomyelitis with the use of circular external fixation is effective in achieving infection control and union in these complex cases.
authors.affiliation: Department of Orthopaedic Surgery, Tygerberg Hospital, University of Stellenbosch, Cape Town, 7505, South Africa. Electronic address: nferreira@sun.ac.za.
authors.forename: Nando
authors.initials: N
authors.lastname: Ferreira
authors.affiliation: Department of Orthopaedic Surgery, Greys hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, 3201, South Africa.
authors.forename: Leonard Charles
authors.initials: LC
authors.lastname: Marais
authors.affiliation: Department of Orthopaedic Surgery, Greys hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, 3201, South Africa.
authors.forename: Charles
authors.initials: C
authors.lastname: Serfontein
mesh_terms: D000328:Adult; D000368:Aged; D003646:Debridement / Q000009:adverse effects / Q000379:methods*; D016267:External Fixators; D005260:Female; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000517:prevention & control / Q000601:surgery*; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chronic osteomyelitis; Circular fixator; Humerus; Ilizarov; Septic non-union