Clinico-pathological analysis of osteomyelitis in cancrum ois (Noma) patients seen in Noma children hospital, Northwest Nigeria

Background: Cancrum oris is a rapid and devastating infectious disease of the orofacial region, which can be life threatening in its fulminant stage. Infection of bone (osteomyelitis) is a possible sequelae of Noma (cancrum oris) and is more likely due to late presentation especially in our environment. A literature search revealed scanty research describing osteomyelitis in Noma patients. Objective: To analyze the clinico­pathology of osteomyelitis in Noma patients diagnosed and treated at Noma Children Hospital, Sokoto.Methods: The design was a 2-year retrospective study of records of Thirty­two patients who had sequestrectomy secondary to osteomyelitis in Noma (Cancrum oris). Age, gender, jaws affected and side of involvement were analyzed Results: The age ranged from 2­11 years with mean ±standard deviation 5.47 ± 2.68 years was recorded. Osteomyelitis in Noma patients was found among 17 (53.10%) males compared to 15 (46.90%) females. In 20 (62. 50%) of the cases, anterior maxillary involvement was observed and the remaining 12 (37. 50%) was found at the mandibular posterior region and it is more common on the left side. Result of histopathology showed both acute and chronic inflammatory cells. Necrosis and bone hyperactivity was observed in most of the slides. Conclusion: Osteomyelitis is a common complication of Noma and its treatment is of paramount importance for adequate management of Noma patients.

Recurrent chronic suppurative osteomyelitis of the mandible.

Osteomyelitis of the maxillofacial skeleton is a rare condition in recent times. The combination of antibiotic therapy and surgical debridement is effective in the treatment of chronic suppurative osteomyelitis (CSO). This case report describes the successful surgical treatment of CSO of the mandible in an 18-year-old adult. Treatment included a pre-surgical course of antibiotics followed by sequestrectomy, resection of the coronoid process and removal of the pathologically fractured condylar process of the left side of the mandible. On post-operative clinical review at 1 week, the extra oral draining sinus healed with improved mouth opening.

The Treatment of Infected Nonunions of Femur using Sequestrectomy and Distraction Osteogenesis / 대한정형외과학회잡지

PURPOSE: From this study we are to know the result of distraction osteogenesis for infected nonunions of femur using sequestrectomy and Ilizarov external fixator. MATERIALS AND METHODS: 17 patients who had distraction osteogenesis using external fixator and also had more than 2.5 cm bone loss after sequestrectomy for having infected nonunions of femur from 1991 to 2005. Their average age was 32.4 (range, 10-60) years and mean follow up period was 22 (range, 14-36) months. We used Healing index as an index for bone formation. The results were divided into bone results and functional results and analyzed by grading. Also we estimated the complication according to the Paley's classification. RESULTS: After seqestrectomy, bone defect was ranged from 5cm to 13 cm (average, 7.3 cm) and The average of transportation was 5.8 cm (range, 3-10 cm). HI was 47.4 (27.17-65.80) days/cm. Solid bony union occurred in the all cases after surgery but, 4 cases needed bone graft at docking site. According to the final examination there were 2 cases with leg-length discrepancy that is bigger than 2.5 cm and the average size of was 1.0 cm. CONCLUSION: We consider distraction osteogenesis using Ilizarov external fixator as useful method to restore bone loss caused after sequestrectomy for infected nonunions of femur.