Clinical Cases of Post-Traumatic Chronic Osteomyelitis: A Retrospective Study

Abstract

Background: Post-traumatic chronic osteomyelitis (PTCO) is an infrequent but severe complication of fracture treatment and is often resistant to surgical therapy. Early diagnosis of PTCO is essential but difficult because of non-specific clinical signs. Several diagnostic imaging procedures are available, but evidence-based algorithmic models for choosing the most suitable technique are lacking. The objective of this study was to review the diagnosis, clinical course, and morbidity of PTCO. Methods: A retrospective study of patients diagnosed with PTCO from 1991 to 2001 was carried out. Results: Twenty-three patients (mean age 31 years, range 4-69 years, M/F ratio 14/9) were reviewed. Mean follow-up from initial trauma was 13 years (median 8.4 years, range 7 months-60 years). During this period, on average an individual patient underwent 21 diagnostic imaging procedures for PTCO and four hospitalizations for operative treatment of PTCO. Laboratory parameters were inconclusive in half of the investigations. Morbidity was high, with 14 patients still being under outpatient control and five other patients having had an amputation. Conclusions: Patients with PTCO form a young population and morbidity is high. Therefore, the most benefit would be obtained by improving the diagnosis in order to exclude or confirm PTCO in an early phase and to develop benchmarks for treatment follow-up.

Key words

Complications - fracture treatment - diagnostic procedures - outcome

References

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