Clinical observation of osteomyelitis / 대한정형외과학회잡지

ABSTRACT

The authors did a clincal analysis of 95 cases of the osteomyelitis. Among them 72 were hematogenous in origin 12 were secondary to open fracture 6 were direct extension from adjascent soft tissue infection 5 were complicated after open reduction of fracture, who were treated at Dept. of Orthopedics of Catholic Medical College for past 3 years from 1968 to 1971. Through this study following result were obtained 1. Most of the patient were under age of 16 Years, In acute hematogenous osteomyelitis, over 80% of patient were under age of 12 years. Males were more frequently affected than females. 2. Generally, femur, tibia and humerus were most frequently affected than the others. In acute osteomyelitis, distal femur and proximal tibia were the most frequent site of involvement. 3. In acute osteomyelitis, early decompression, like drilling or fenestration operation gave more satisfactory result than the simple soft tissue drainage. Immediate surgical intervention with massive antibiotics administration is stressed without hesitation when diagnosis is made. The group treated within a week after onset gave relatively good result in this series. 4. Primary closure of the wound in acute osteomoelitis were considered not to be the good method which is usually adopted as procedure in the chronic type. 5. In the chronic osteomyelitis, continuous tube irrigation after saucerization was adopted when the bony defect is large. Primary closure of the wound were adopted in the case when surgical defect is small in size less than 4cm in diameter. 6. Treatment of the osteomyelitis complicated after open reduction of the fracture were generally treated with focal curettage and removal of fixative device when clinical union is evident, also fixative devices were out even in the group which were not united clinically but redisplacement is expected not to take place. In this group external support was given until fracture healing. Bony window was also made for drainage when cavitary change develped around the tip of nail.