Mono-Lateral External Fixation for Treatment of Femoral Osteomyelitis

Abstract

Background and Aim Maintenance of stability using external fixation devices is an important principle to ensure successful treatment of osteomyelitis (OM). In this study, we report our experience with femoral OM treated with acute compression and bone transport using the Orthofix limb reconstruction system (LRS). Patients and Methods This prospective study included 30 consecutive patients with femoral OM. LRS insertion and corticotomy were done according to the standard technique. Radiographic evaluation was performed every 2 weeks during the distraction phase and every 2–4 weeks during the consolidation phase. The clinical outcome measurements included union time, limb length discrepancy, additional operative procedures, refracture and infection. Results The present study included 30 patients with femoral OM. They comprised 27 males (90.0%) and 3 females (10.0%) with an age of 28.1 ± 15.6 years. All, except one, achieved union with a mean union time of 8.6 months (range 4–20 months). The mean union time for acute compression was 7.6 months (range 4–20 months) while for patients with bone transport it was 14.5 months (range 12–18 months). The mean limb length discrepancy was 1.8 cm (range 0–4 cm). At the end of the follow=up, two patients were not able to ambulate without support; one due to non-union and one due to paraplegia. Conclusion The present study identified treatment of femoral OM using LRS as a feasible and effective technique with good outcomes. Reported complications could be adequately managed in most cases.

Osteomielite: uma revisão bibliográfica

“…O paciente que é acometido por uma osteomielite crônica femoral pode seguir com o tratamento de desbridamento cirúrgico, devido a presença da infecção é administrado antibióticos. Como existe a presença de músculos ao redor a fixação do fêmur torna-se complicada, sendo optada a lateral por ser a melhor solução e oferecer um conforto melhor ao paciente (Mohd Yusof et al, 2022).…”

Chronic humeral osteomyelitis in an adult with sickle-cell disease

“…To maintain stability, some authors propose the use of external fixators as a fundamental component of treatment [ 24 ]. Despite being part of our preoperative plan, this was dismissed due to the satisfactory bone quality and sufficient integrity of the humeral structure following curettage, and it was considered that the remaining healthy bone tissue was sufficient to allow immobilized management of a plaster orthosis.…”