Osteoplasty in Surgical Treatment of Chronic Exogenous Osteomyelitis

Abstract

Introduction : The aim of our research is to show the role of osteoplasty and surgical treatment of chronic exogenous osteomyelitis and to present exact rules of performing its different types - primary osteoplasty (PO - right after the renovation of the area of the infection), primary delayed osteoplasty (PDO - till the 30th day after the renovation of the area of infection ) and secondary osteplasty (SO - after more than 30 days after the renovation of the area of infection ). Many authors recommend performing of PO and many others claim that the best way of performing the procedure is PDO, based on results of their own researches. The dispute PO or PDO (SO) has continued for many years, but recently with the improved possibilities of planning ahead, the various ways of antibacterial treatment, the osteoplasty suggestions of the second group authors is starting to sound more convincing. Materials and Methods: We present 255 patients suffering from chronic exogenous osteomyelitis with defect of the bones, which means cases, in which two types of activities need to be performed:1. Removing bone infection from the osteomyelitic area by sanitizing it; 2. Creating good conditions for the bone consolidation via fixation (internal, external) and osteoplasty. Results: In 205 cases, we have sanitized the osteomyelitic area by using fixation and osteoplasty at the same time (PO). In 50 cases, because of the inability to perform PO, we proceeded with PDO or SO later. A good result would be a lack of bone infection and presence of bone consolidation for the first year. We observed that in 90% of PO and 60% of PO and PDO. Because of our database, we consider that PO should be prioritized if sanitizing the osteomyelitic area is performed perfectly. Conclusions : Based on our data we consider that PO is a priority if the renovation of the area of infection is performed perfectly.