Chronic Osteomyelitis

Question 1

What is chronic osteomyelitis

Answer 1

Chronic osteomyelitis represents a progressive inflammatory process caused by pathogens, resulting in bone destruction and sequestrum formation.

Question 2

What is sequestrum

Answer 2

Dead bone tissue formed within a diseased or injured bone, typically in chronic osteomyelitis

Question 3

How can chronic osteomyelitis occur?

Answer 3

May follow acute osteomyelitis (now much rarer in children)
May start de novo
- following operation
- following open # (poss. many years earlier)
- immunosuppressed, diabetics, elderly, drug abusers, etc.

Question 4

What bacteria are involved in chronic osteomyelitis

Answer 4

ften mixed infection
usually same organism(s) each flare-up
mostly Staph. Aureus, E. Coli, Strep. pyogenes, Proteus

Question 5

What is treatment for chronic osteomyelitis

Answer 5

Long-term antibiotics?
- local (gentamicin cement/beads, collatamp)
- systemic (orally/ IV/ home AB)
Eradicate bone infection- surgically (multiple operations)
Treat soft tissue problems
Deformity correction?
Massive reconstruction?
Amputation? (how many operations/ years later?)

Question 6

What are compications of chronic ostemyelitis

Answer 6

Chronically discharging sinus + flare-ups
Ongoing (metastatic) infection (abscesses)
Pathological fracture
Growth disturbance + deformities
Squamous cell carcinoma (0.07%)