Two-stage management of chronic osteomyelitis of the long bones. The Belfast technique

Abstract

We treated 37 patients with chronic osteomyelitis of the tibia (25), femur (9), radius (2) and humerus (1) by a twostage technique, comprising radical debridement of all infected bone and soft tissue with the provision of softtissue cover, and delayed autogenous bone grafting when necessary. All patients were reviewed at an average of 49 months (12 to 121). Infection-free bone union was achieved in 34. No patient required amputation. Wide excision of all compromised tissue and the closure of bone within a healthy vascularised soft-tissue envelope are essential if infection is to be eradicated. The combined assessment and management of such patients by an orthopaedic surgeon and a plastic surgeon are advocated.

Chronic osteomyelitis

“…11 The technique most commonly used, however, is the appearance of the bone at the time of surgery, and the presence of punctate bleeding ('paprika sign'). 2,7,[12][13][14] We used this technique to assess whether or not the bone was viable. In all three groups appropriate antibiotics were given for six weeks intravenously and then orally for six weeks.…”

Limb salvage in advanced chronic osteomyelitis in children

“…In children, there have been few reports of resection of the shaft sequestrum followed by reconstruction and a successful functional result [2,5,9].…”

Plating of Femoral Shaft Fractures: the Experience in an African Teaching Hospital

“…The cause of implant failure in our series can be attributed to inadequate reduction and use of short plate. There were four cases of deep infection (2.5%t), all responded to plate removal coupled with Belfast technique of treating chronic osteomyelitis [26]. The complication rate of 5.7% is low when compared with 15-30% reported by other authors [8,21,27,28] but compares to 6.3% reported by Cheng [9] & 7% by Geissler [15].…”