Klassifikation der Osteomyelitis und Osteitis

Schmidt, H. G. K.; Diefenbeck, Michael; Krenn, Veit; Abitzsch, D; Militz, M.; Tiemann, A.; Haustedt, Nils; Gückel, P.; Bühler, M; Gerlach, Ulf-Joachim

doi:10.1055/s-0034-1368620

Cited by 11 publications

(4 citation statements)

References 31 publications

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“…However, these intervals were arbitrarily established based on the authors’ clinical experience. Schmidt et al 13 incorporated these parameters as part of a broad classification for osteomyelitis, but stressed that defining the start time and the time elapsed to infection based on only clinical parameters can be faulty. For these authors, histological assessment is much more precise, particularly when seeking to define whether the infection is acute or chronic (defined as those in which the infectious process leads to chronic inflammatory alterations in the tissue, especially bone necrosis).…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated With the Development of Early Infection After Surgical Treatment of Fractures

Alcântara¹,

Aguiar²,

Neto³

et al. 2018

Acta ortop. bras.

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Objective:Infection after the internal fixation of fractures is a major complication. Early infection is particularly challenging, because it occurs when the fracture is not yet united. The objective of this study is to identify possible factors related to the development of early infection in patients treated with internal fixation for fractures. Method:This retrospective observational study analyzed 24 patients with long bone fractures who underwent internal fixation and developed infections in the post-operatory period. The infections were classified as early (diagnosis in the first two weeks after surgery) or late (diagnosis after 2 weeks). Results:Of the 24 patients studied, 11 (46%) developed early infections and 13 (54%) were diagnosed with late infections. The early infection group was significantly younger (37.8 versus 53.1 [p = 0.05]) and underwent more surgeries prior to internal fixation (1.2 versus 0.2 [p < 0.00]). Conclusion:Risk factors for the development of early infection in the postoperative period should be considered when treating patients with internal fracture fixation in order to diagnose this condition as early as possible. Level of Evidence IV; Case series.

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Section: Discussionmentioning

confidence: 99%

“…For these authors, histological assessment is much more precise, particularly when seeking to define whether the infection is acute or chronic (defined as those in which the infectious process leads to chronic inflammatory alterations in the tissue, especially bone necrosis). 13 - 15 …”

Section: Discussionmentioning

confidence: 99%

Factors Associated With the Development of Early Infection After Surgical Treatment of Fractures

Alcântara¹,

Aguiar²,

Neto³

et al. 2018

Acta ortop. bras.

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“…[ 1 ] Osteomyelitis may occurs in a single type bone tissue, or spreads to the bone marrow, sclerotin, periosteum, and the surrounding soft tissues at the same time. [ 2 – 4 ] According to different etiologies, osteomyelitis can be commonly divided into the following 3 kinds [ 5 , 6 ] : hematogenous osteomyelitis, caused by the bacterium getting into the bone via blood circulation from lesions; traumatic osteomyelitis, caused by open fractures or skeleton surgeries and its secondary infections; and the osteomyelitis caused by infections spreading from the adjacent tissues to the skeleton. Morbidity rate of the disease is higher among men than among women, and the average onset age of the disease is 21.9 years and most patients are below 50 years old.…”

Section: Introductionmentioning

confidence: 99%

Examining the association of MMP-1 gene −1607 (2G/1G) and −519 (A/G) polymorphisms with the risk of osteomyelitis

Kong

Yan

et al. 2017

Medicine

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To investigate the effects of matrix metalloproteinase-1 (MMP-1) gene polymorphisms on the onset of osteomyelitis in Chinese Han population.In all, 80 osteomyelitis patients (case group) and 81 healthy people (control group) were recruited into this case-control study. Polymerase chain reaction-restriction fragment length polymorphism method was utilized to examine the genotypes of MMP-1 polymorphisms (−1607 2G/1G and −519A/G) in the 2 groups. Genotype and allele differences between the case and control groups were analyzed by chi-square test. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated to present the association strength between MMP-1 gene polymorphisms and osteomyelitis.Frequencies of −1607 2G/2G genotype between the case and control groups were statistically significant (P = .025). Compared with 1G/1G genotype carriers, the 2G/2G genotype carriers had 1.605 times risk of developing osteomyelitis (OR 2.605, 95% CI 1.116–6.082). Meanwhile, the 2G allele significantly associated with the risk of osteomyelitis (OR 1.735, 95% CI 1.115–2.701). In addition, frequency of −519GG genotype was obviously higher in case group than that in control group (P = .024), and GG genotype related to an increased risk of osteomyelitis (OR 2.792, 95% CI 1.127–6.917). Whereas, the −519G allele may be a susceptible factor for osteomyelitis (OR 1.622, 95% CI 1.038–2.536).The MMP-1 −1607 (2G/1G) and −519 (A/G) polymorphisms may contribute to the onset of osteomyelitis.

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“…Zahlreiche Klassifikationen existieren. Aktuell wurde eine neue detaillierte Klassifikation publiziert, die auch Hinweise auf die erforderliche Therapie geben soll [3]. Denn die Behandlung einer Osteomyelitis ist komplex, langwierig und nicht zuletzt kostenintensiv [4,5].…”

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Validierung des Osteomyelitis-Diagnose-Scores anhand einer retrospektiven Analyse von 100 Patienten mit Tibiapseudarthrose

et al. 2016

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The accurate diagnosis of "osteomyelitis" is difficult and is often delayed. However, early and radical therapy of osteomyelitis is essential. The osteomyelitis diagnosis score (ODS) was developed to predict the probability of osteomyelitis. The aim of our study was to validate the ODS and to investigate its practicability in daily routine. The ODS is based on five diagnostic procedures: 1. clinical history/risk factors, 2. clinical examination/laboratory results, 3. diagnostic imaging, 4. microbiology and 5. histopathology. Each diagnostic procedure includes numerous individual findings, which are rated with 1-6 points, depending on their relevance. If the sum of the five diagnostic criteria is ≥ 17 points, the diagnosis "osteomyelitis" can be viewed as safe, between 8-17 points as probable and between 2-7 points as possible. This retrospective study included 100 patients with non-union of the tibia (2002-2010). The patients were classified into two groups: septic non-union of the tibia (experimental intervention; gold standard: positive detection of bacteria and/or positive histology) and aseptic non-union of the tibia (control intervention; no detection of bacteria and/or histology). Epidemiological data, the score's total number of points and the number of points of the score's five diagnostic procedures were analysed. 71 patients exhibited aseptic non-union of the tibia, 29 patients septic non-union. Patients with septic non-union obtained a mean of 20.8 points, and 24 at least 18 points; the diagnosis "osteomyelitis" is then presumed to be certain. Patients with aseptic non-union obtained a mean of 11.3 points, and only 3/71 patients received > 17 points. Both groups obtained the majority of points in the diagnostic procedure "clinical history". The difference between the two groups is highly significant (p < 0.001). The score's sensitivity is 82.8 %, with a specificity of 95.8 %. The ODS was proved to be a valid score. Patients with septic non-union were identified, even if bacteria were not detected. However, the use of the ODS is demanding, as there are 104 individual findings. Many of these individual findings were negative in all patients. It would be desirable to optimise ODS, by reducing the number of queried parameters, without reduction sensitivity.

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Klassifikation der Osteomyelitis und Osteitis

Cited by 11 publications

References 31 publications

Factors Associated With the Development of Early Infection After Surgical Treatment of Fractures

Factors Associated With the Development of Early Infection After Surgical Treatment of Fractures

Examining the association of MMP-1 gene −1607 (2G/1G) and −519 (A/G) polymorphisms with the risk of osteomyelitis

Validierung des Osteomyelitis-Diagnose-Scores anhand einer retrospektiven Analyse von 100 Patienten mit Tibiapseudarthrose

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