Results in treatment of chronic osteomyelitis

Objective To study the results of chronic osteomyelitis treated by various operation. Methods There were 38 cases of bone lesions in which 14 femora, 16 in tibia, I in humeral, 3 in fibula, 1 in calcanea, 2 in phalanx and 1 in costae. The causes of osteomyelitis were haematogenous in 27 cases and infected open fracture in 11 cases. The duration osteomyelitis varied from 5 months to 60 years. Methods The lesion were thoroughly excised and filled by muscular flap or musculocutaneous in large bony cavity in 5 cases, irrigation with antibiotics in small bony cavity in 25 cases, Orr's operation in 5 cases and excision of phalanx in 3 cases. Results All cases were followed-up for from I to 15 years. All of 5 cases that filled by muscular flap were all cured in primary stage. 24 cases of irrigation method healed and 1 case of fibula osteomyelitis relapsed 2 years later. There were 4 cases of Orr's method healed in 3～5 months and one case of calcaneus did not heal until 1 year.The case of phalanx escision was healed. Conclusion Thoroughly excision of osteomyelitis is a key step in the treatment of chronic osteomyelitis. As for calcaneus, it was difficult to clean away thoroughly, thus this was the of recurrence. Muscular flap filling was the choice of treatment for large bony cavity and irrigation for small bony cavity. Orr's treatment may-be used at the site where muscular flap was not available and bone healing occurred with in 3～5 months.