Chronic osteomyelitis treated by operation

Objective To observe the results of chronic osteomyelitis treated by various operation. Materials There were 32 bone lesions in 31 cases in which 20 in tibiae, 5 in femora, 3 in calcanea, 2 in tarsi; 1 in phalanx and I in ilium. The causes of chronic osteomyelitis were haematogenous in 5 cases, infected open fracture in 25 and gunshot in 1. The duration of osteomyelitis varied from 4 months to 4 years in open fracture, average 10 years in haematogenous osteomyelitis and 30 years in gunshot. Methods The lesion were thoroughly excised and filled by muscular flap or mus- culocutaneous in large bony cavity in 14 cases, irrigation with antibiotics in small bony cavity in 5 cases, Orr's operation in 12 cases and excision of phalanx in 1 case. Results All cases had been followed - up from 3 months to 5 years. All of 14 cases that filled by muscular flap were all healed in primary stage. 4 cases of irrigation method healed and 1 case of ilium osteomyelitis recurred 3 months later. There were 11 cases of Orr' s method healed in 4 - 6 months ami one case of calcaneus did not heal until 8 months. The case of phalanx excision was healed. Conclusions ①Thoroughly excision of osteomyelitis is a key step in the treatment of chronic osteomyelitis, As for ilium or calcaneus, it was difficult to clean away thoroughly , thus this was the reason of recurrence. ②Muscular flap filling was the choice of treatment for large bony cavity and irrigation for small bony cavity.③Orr's treatment may be used at the site where muscular flap was not available and bone healing occurred within 4 - 6 months.