Osteomyelitis in Long Bones

• Published in: Journal of bone and joint surgery. American volume Vol. 86; no. 10; pp. 2305 - 2318
• Main Authors: Lazzarini, Luca, Mader, Jon T, Calhoun, Jason H
• Format: Journal Article
• Language: English
• Published: United States Copyright by The Journal of Bone and Joint Surgery, Incorporated 01.10.2004
• Subjects: Adult; Algorithms; Anti-Bacterial Agents - therapeutic use; Child; Debridement; Humans; Osteomyelitis - diagnosis; Osteomyelitis - physiopathology; Osteomyelitis - therapy; Reconstructive Surgical Procedures
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/00004623-200410000-00028

Osteomyelitis in long bones remains challenging and expensive to treat, despite advances in antibiotics and new operative techniques.Plain radiographs still provide the best screening for acute and chronic osteomyelitis. Other imaging techniques may be used to determine diagnosis and aid in treatment decisions.The decision to use oral or parenteral antibiotics should be based on results regarding microorganism sensitivity, patient compliance, infectious disease consultation, and the surgeonʼs experience. A suppressive antibiotic regimen should be directed by the results of cultures.Standard operative treatment is not feasible for all patients because of the functional impairment caused by the disease, the reconstructive operations, and the metabolic consequences of an aggressive therapy regimen.Operative treatment includes débridement, obliteration of dead space, restoration of blood supply, adequate soft-tissue coverage, stabilization, and reconstruction.