Abstract
BackgroundNo standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation. Our team evaluates the clinical efficacy of the modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny–Mader type.MethodsNinety-five wounds were reviewed from March 2009 to February 2016 in our hospital. Sixty-one wounds were treated by the modified algorithm as follows: stable hardware + bone not healed Cierny–Mader 1 type = remove hardware, temporary stabilize; stable hardware + bone not healed Cierny–Mader 2 type = retain hardware ; stable hardware + bone not healed Cierny–Mader for type 3 and type 4 = remove hardware, temporary stabilize/Ilizarov technique; unstable hardware + bone not healed = remove hardware, temporary stabilize/Ilizarov technique; and stable hardware + bone healed = remove hardware. Thirty-four wounds were treated by the conventional algorithm. Autodermoplasty, flap transfer, myocutaneous flap, and other methods including antibiotic irrigation and drug delivery system were used in wound repair.ResultsThe patients treated with modified algorithm had a significantly reduced recurrence (P < 0.01) and increased results of negative bacterial cultures (P < 0.01); however, a decrease in the number of retained hardware cases was observed (P < 0.05). For those treated with tissue reconstruction, there was no significance (P > 0.05) compared with the conventional group.ConclusionsThe modified algorithm for the postoperative osteomyelitis following fracture fixation according to the stability of the hardware and Cierny–Mader type represents a good clinical efficacy in the management of postoperative osteomyelitis. This procedure is simple and shows promising results; more clinical evidence is needed to confirm the existing findings and optimize the treatment of postoperative osteomyelitis following fracture fixation.
Highlights
No standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation
Postoperative osteomyelitis (PPO) following fracture fixation is characterized by infection of the bone and marrow, and most caused by direct or indirect local invasion by microorganisms from adjacent contaminated soft tissue after trauma, during reconstructive bone
Tan et al Journal of Orthopaedic Surgery and Research (2020) 15:212 evaluation of implants is critical to efficacy interpretation for improving outcomes in the treatment of PPO following fracture fixation, tactics based upon clinical evaluation should be focused on the mechanism of the implant; there is minimal research progress and few innovations that change the clinical practice and outcomes
Summary
No standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation. Our team evaluates the clinical efficacy of the modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny–Mader type. Postoperative osteomyelitis (PPO) following fracture fixation is characterized by infection of the bone and marrow, and most caused by direct or indirect local invasion by microorganisms from adjacent contaminated soft tissue after trauma, during reconstructive bone. Tan et al Journal of Orthopaedic Surgery and Research (2020) 15:212 evaluation of implants is critical to efficacy interpretation for improving outcomes in the treatment of PPO following fracture fixation, tactics based upon clinical evaluation should be focused on the mechanism of the implant; there is minimal research progress and few innovations that change the clinical practice and outcomes. These patients have a poor prognosis for cure [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
