Effectiveness of Free Gracilis Muscle Flaps in the Treatment of Chronic Osteomyelitis With Purulent Fistulas at the Distal Third of the Tibia in Children

Hoang, Nguyen The; Staudenmaier, R.; Feucht, A.; Hoehnke, Christoph

doi:10.1097/bpo.0b013e31819903e1

Cited by 11 publications

(6 citation statements)

References 29 publications

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“…First, this is a retrospective evaluation of a limited number of patients treated with the induced membrane. However, although the total number of cases was relatively small, it was similar to numbers reported in other published studies (Table 3) [15,[27][28][29][30][31][32]. Furthermore, as discussed by Feise, Bit must be careful to focus not only upon statistical significance (adjusted or not), but also upon the quality of the research within the study and the magnitude of differences [ 33].…”

Section: Discussionsupporting

confidence: 74%

Chronic infection and infected non-union of the long bones in paediatric patients: preliminary results of bone versus beta-tricalcium phosphate grafting after induced membrane formation

Rousset

Walle

Cambou

et al. 2017

International Orthopaedics (SICOT)

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Section: Discussionsupporting

confidence: 74%

Chronic infection and infected non-union of the long bones in paediatric patients: preliminary results of bone versus beta-tricalcium phosphate grafting after induced membrane formation

Rousset

Walle

Cambou

et al. 2017

International Orthopaedics (SICOT)

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“…Although free gracilis muscle transfer has been used for the treatment of fistulae in chronic osteomyelitis of the tibia 26 and to reconstruct soft-tissue defects, it was our practice to allow wounds to granulate after eradication of infection. In eight patients we performed splitskin grafts, and in one with type B4 chronic tibial osteomyelitis a local fasciocutaneous flap was used after successful fibula transfer (Table III).…”

Section: Figmentioning

confidence: 99%

Chronic haematogenous osteomyelitis in children

Beckles

Jones

Harrison³

2010

The Journal of Bone and Joint Surgery. British volume

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We present a retrospective review of 167 patients aged 18 years and under who were treated for chronic haematogenous osteomyelitis at our elective orthopaedic hospital in Malawi over a period of four years. The median age at presentation was eight years (1 to 18). There were 239 hospital admissions for treatment during the period of the study. In 117 patients one admission was necessary, in 35 two, and in 15 more than two. A surgical strategy of infection control followed by reconstruction and stabilisation was employed, based on the Beit CURE radiological classification of chronic haematogenous osteomyelitis as a guide to treatment. At a minimum follow-up of one year after the end of the study none of the patients had returned to our hospital with recurrent infection. A total of 350 operations were performed on the 167 patients. This represented 6.7% of all children's operations performed in our hospital during this period. One operation only was required in 110 patients and none required more than three. Below-knee amputation was performed in two patients with chronic calcaneal osteomyelitis as the best surgical option for function. The most common organism cultured from operative specimens was Staphylococcus aureus, and the tibia was the bone most commonly affected. Polyostotic osteomyelitis occurred in four patients. We believe this is the largest reported series of patients treated for chronic haematogenous osteomyelitis.

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“…The ankle joint destruction accompanying infection is very common. Thorough debridement will result in large bone defects and the sacrifice of the joint (7,14). Many authors have presented a variety of surgical techniques for the treatment of lower extremity osteomyelitis, including debridement and drainage, reconstruction of defects in soft tissue and bone tissue (1,4,6).…”

Section: Discussionmentioning

confidence: 99%

Comprehensive and individualized surgical treatment strategy for distal tibia osteomyelitis: a retrospective study of 70 patients

Alimujiang

Jia

Guo

et al. 2023

Preprint

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Background Distal tibia osteomyelitis (DTO) treatment has become a challenging problem due to its difficult treatment and special location. Our goal is to provide a comprehensive and individualized treatment strategy, and to investigate the associated complications.Methods We retrospectively analyzed the data of 70 patients with DTO diagnosed and treated in our hospital from January 2015 to January 2022. The average age was 42.5 years (12–73 years), there were 34 cases accompanied by bone defects, and the average length of the bone defect was 3.2 cm (2 cm–17 cm). We divided the patients into three groups based on infection severity and specific location: 25 cases of a simple type (S type), 23 cases of complex ankle non-involved type (CAN type), and 22 cases of complex ankle involved type (CAI type). Comprehensive individualized treatment, including debridement, reconstruction, arthrodesis, and other surgical methods, was performed on patients of various types, rehabilitation exercises were guided, and patients were closely monitored. The efficacy was assessed using the following criteria: (1) treatment and related complications; (2) infection and defect healing; (3) improvement of ADL, VAS, and AOFAS scores; (4) evaluation of patients undergoing Ilizarov distraction osteogenesis; and (5) evaluation of patients undergoing ankle arthrodesis.Results The follow-up time was 30 months (10–84 months). With the exception of three patients who required amputation due to aggravated infection and concomitant basic diseases, all patients achieved infection control and healing, and the complications were properly treated. Three scores of patients with different types were significantly improved, and the differences were statistically significant. Patients undergoing Ilizarov distraction osteogenesis had satisfactory results, and the superior rates of ASAMI bone evaluation and function evaluation were 89%. All patients with ankle arthrodesis finally achieved bone healing, and the average fusion time was 4.5 months (3–7 months).Conclusion The comprehensive individualized treatment strategy is reliable for the treatment of DTO, as it can guide individualized treatment under different conditions, solve the problem of bone and soft tissue defects while controlling infection, reduce complications and properly handle them, and save as much function of the affected limb as possible.

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Effectiveness of Free Gracilis Muscle Flaps in the Treatment of Chronic Osteomyelitis With Purulent Fistulas at the Distal Third of the Tibia in Children

Abstract: IV.

Cited by 11 publications

References 29 publications

Chronic infection and infected non-union of the long bones in paediatric patients: preliminary results of bone versus beta-tricalcium phosphate grafting after induced membrane formation

Chronic infection and infected non-union of the long bones in paediatric patients: preliminary results of bone versus beta-tricalcium phosphate grafting after induced membrane formation

Chronic haematogenous osteomyelitis in children

Comprehensive and individualized surgical treatment strategy for distal tibia osteomyelitis: a retrospective study of 70 patients

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