Abstract
The treatment of osteomyelitis is still a difficult problem in orthopaedic surgery. We reviewed the results of the treatment of osteomyelitis in last four years.
The patients were 8 males and 1 female. The age of the patients ranged from 30 to 75 years (averaged age was 56 years old). The site were five femurs, four tibias, one humerus, and one ulna.
The pathogens cultivated were Methicillin resistant staphylococcus aureus (MRSA) in 5 cases, Methicillin sensitive staphylococcus aureus (MSSA) in 4, Pseudomonas Aeruginosa in 2, and Methicillin resistant staphylococcus epidermidis (MRSE) in 1.
In all the patients, debridement and resection of the infected bone were performed at first. After resection, in 6 of 9 patients, the defects of bone were small, and we performed muscle flap transposition. In 2 cases with MRSA and 1 case with MRSE, the defect of bone was large, and vascularized bone graft was performed.
In all cases, the osteomyelitis healed after the operation.
Recently, osteomyelitis with MRSA is increasing, and its treatment is more difficult than those with other pathogens. In treatment of osteomyelitis with MRSA, the debridement and resection of infected dead bone are most important as well as those with other pathogens. The vascuralized bone graft is very useful for the reconstruction of large bone defect after debridement.
