Clinical characteristics of limb traumatic osteomyelitis in South China / 中华创伤骨科杂志

Objective:To characterize limb traumatic osteomyelitis in a regional trauma center in South China.Methods:The case system at Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital was searched for the data of confirmed limb traumatic osteomyelitis from January 1, 2010 through September 1, 2019. The clinical items collected were gender, age of onset, cause of injury, injury nature (open or closed), infected site (single site or multiple sites), intraoperative culture of pathogenic microorganisms, number and type of pathogenic microorganisms, and amputation. The above data were sorted out and analyzed statistically.Results:A total of 674 patients suffered limb traumatic osteomyelitis in South China with a male to female ratio of 4.81∶ 1. The limb traumatic osteomyelitis resulted mainly from open injury (64.09%, 432/674). It was mainly caused by a traffic accident (39.51%, 211/534). It was featured by single-site infection (83.68%, 564/674). It affected mainly the lower limbs: the tibia (53.19%, 300/564), the femur (18.97%, 107/564), the calcaneus (11.70%, 66/564) and other foot bones (4.61%, 26/564). The positive rate of intraoperative microorganisms culture was 65.26% (355/544). In the majority of patients (74.65%, 265/355), the traumatic osteomyelitis was caused by infection of a single pathogenic microorganism. The most common single pathogenic microorganism was Staphylococcus aureus (38.11%, 101/265), followed by Pseudomonas aeruginosa (20.00%, 53/265). The rate of amputation related to traumatic osteomyelitis was 3.71% (25/674), and the overall disability rate was 4.45% (30/674).Conclusions:In South China, more males were prone to limb traumatic osteomyelitis. Most cases were secondary to an open fracture and caused by a traffic accident. Traumatic osteomyelitis usually occurred at a lower limb. The most common pathogenic microorganism was Staphylococcus aureus.

Clinical application of local antibiotic carriers in infected bone defects / 中华创伤骨科杂志

Early management of open extremity fractures and treatment of chronic osteomyelitis,in general,require thorough debridement.Radical debridement of the contaminated or infected bone tissues usually results in bone defects.If such bone defects are not dealt with properly,they can easily deteriorate into infected ones.Treatment of infected bone defects can be extremely complicated.Application of local antibiotic delivery system can simultaneously fill the bone defects,prevent and treat the infection by delivering a high concentration of antibiotics to the lesion.The clinical antibiotic carriers can be divided roughly into 2 types:non-biodegradable and biodegradable.The biodegradable type involves bioceramic,natural polymer,synthetic polymer and composite materials.This literature review summaries the characteristics and clinical applications of current local antibiotic carriers.