A Novel Method for Surgicaltreatment of Osteomyelitis of Distal Phalanx: A Clinical Case

Abstract

— Background: Osteomyelitis is an infectious-inflammatory destructive bone disease caused by nonspecific and specific microflora, or microbial communities. Diabetes mellitus is the most common pathology associated with osteomyelitis and may be responsible for exacerbation of chronic osteomyelitis. Objective: to demonstrate a new patented technique for surgical treatment of osteomyelitis of distal phalanx (I finger) on the example of a clinical case. Methods: A female patient P. 34 years old, who has type 2 diabetes mellitus, decompensated. Daily glucosometry shows changes in capillary blood glucose from 7 to 25 mmol/L during the last month; the last blood test for HbA1c — 10.4%, it should be noted that the patient adheres to the diet prescribed by the endocrinologist and receives drug therapy according to treatment standards, however, attempts to compensate the disease have been failed. The patient suffers from obesity of 1 degree (BMI = 30.11). Results: Operation: after preparation of the surgical site with Betadin’s solution, local anesthesia according to Oberst-Lukashevich (injection of 3 ml 2% Lidocaine solution on each side into the lateral surfaces of the I finger of the right hand from the place of harness application, proximal to the intervention area) was provided. Extraction of the nail plate with dissection of soft tissues along the phalanx and along the projection of the nail bed and rotation of tissues downwards to expose the bone destruction focus. Then necrectomy of the damaged bone was performed followed by sanitization and returning of soft tissues to their place without suturing. Conclusion: The given example of surgical treatment of finger osteomyelitis has undeniable advantages due to a number of reasons: elimination of traumatization of finger’s working surface, achievement of cosmetic effect, preservation of aesthetic and function of hand, as well as all types of sensitivity of finger skin. It is worth noting that this method of surgical treatment of osteomyelitis has more favorable course of the postoperative period due to a shorter duration of pain syndrome and the general reaction of the body.