Extremity chronic osteomyelitis in a population of North East India: epidemiology, clinical characteristics and management

Abstract

<p class="abstract"><strong>Background:</strong> The purpose of this study was to review the epidemiology, clinical features and the management of extremity chronic osteomyelitis in a population of North East India and to provide evidenced based guidelines for early diagnosis and treatment.</p><p class="abstract"><strong>Methods:</strong> We retrospectively reviewed patients who were diagnosed and treated for extremity chronic osteomyelitis at a tertiary care hospital at Shillong in North East India. Medical records for all patients were analysed and details on gender, age at incidence, anatomical site, infecting organisms, levels of inflammatory markers, and the various treatment modalities were evaluated.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 131 patients (96 males and 35 females) were included in this study. The median age at first diagnosis was 17 years for all. Infections caused by hematogenous osteomyelitis was found to be slightly more than those of traumatic origin. All patients had single site infections with a majority of lesions affecting the lower extremities. The tibia was the most common site in traumatic osteomyelitis while the femur was mostly involved in hematogenous osteomyelitis. The positive rate for all cultures was at 57.25% with the most commonly encountered organism being <em>Staphylococcus aureus</em>. Treatment methods used in our study included radical debridement with the use of local and systemic antibiotics and reconstruction of bony or soft tissue defects. The overall infection control rate was 96.18%.</p><p><strong>Conclusions:</strong> The findings from this study can provide information for early diagnosis and treatment of this form of bone infection particularly in this part of the country. </p>