Cases reported "Osteomyelitis"

Filter by keywords:



Filtering documents. Please wait...

1/168. Salvage of contaminated fractures of the distal humerus with thin wire external fixation.

    Fractures and osteotomies of the distal humerus that are contaminated or infected represent a difficult management problem. Stable anatomic fixation with plates and screws, the acknowledged key to a good result in the treatment of bicondylar fractures, may be unwise. A thin wire circular (Ilizarov) external fixator was used as salvage treatment in such complex situations in five patients. The fixator allowed functional mobilization of the elbow while allowing achievement of the primary goal of eradicating the infection or colonization. Two patients required a second operation for fixation of a fibrous union of the lateral condyle. One patient with a vascularized fibular graft later required triple plate fixation for malalignment at the distal host and graft junction. Four of five patients ultimately achieved complete union. The fracture remained ununited in one patient who has declined additional intervention. All five patients achieved at least 85 degrees ulnohumeral motion, two after a secondary elbow capsulectomy performed after healing was achieved. This experience suggested that the Ilizarov construct, although not a panacea, represents a reliable method of skeletal stabilization that allows functional mobilization while elimination of infection or colonization is ensured. If necessary, stiffness and incomplete healing can be addressed with an increased margin of safety at subsequent operations.
- - - - - - - - - -
ranking = 1
keywords = fracture
(Clic here for more details about this article)

2/168. femur osteomyelitis due to a mixed fungal infection in a previously healthy man.

    We describe a previously healthy, 22-year-old man who, after a closed fracture of the femur and subsequent operation, developed chronic osteomyelitis. Within a few days, infected bone fragments, bone, and wound drainage repeatedly yielded three different filamentous fungi: aspergillus fumigatus, aspergillus flavus, and Chalara ellisii. Histologic examination of the bone revealed septate hyphae. After sequential necrotomies of the femur and irrigation-suction drainage with added antimycotic therapy, the infection ceased and the fracture healed. This case is unique in that it is the only known instance in which a long bone was affected in an immunocompetent individual, with no evidence of any systemic infection, by a mixed population of two different Aspergillus spp. and the rare filamentous fungus C. ellisii. Environmental factors that could potentiate the infection include blood and edema fluid resulting from the surgical procedure and the presence of the osteosynthetic plate.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = fracture
(Clic here for more details about this article)

3/168. Double-stress fracture of the tibia in a ten-year-old child.

    A double-stress fracture of the tibia in a 10-year-old girl is described. Double-stress fracture of the tibia has previously been described in association with osteoarthritic varus deformity of the knee but not, to our knowledge, in a child. It is important to establish the diagnosis of stress fracture in childhood because the differential diagnosis, both clinically and on imaging, includes malignancy that must be excluded while avoiding unnecessary invasive investigations. The site of the lesions, their appearance on magnetic resonance imaging, the absence of any soft-tissue involvement, and the clinical history made the diagnosis possible. The characteristics of stress fracture shown on magnetic resonance imaging are described.
- - - - - - - - - -
ranking = 1.3333333333333
keywords = fracture
(Clic here for more details about this article)

4/168. fluorine-18 fluorodeoxyglucose PET in infectious bone diseases: results of histologically confirmed cases.

    The aim of this study was to evaluate the clinical use of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in acute and chronic osteomyelitis and inflammatory spondylitis. The study population comprised 21 patients suspected of having acute or chronic osteomyelitis or inflammatory spondylitis. Fifteen of these patients subsequently underwent surgery. FDG-PET results were correlated with histopathological findings. The remaining six patients, who underwent conservative therapy, were excluded from any further evaluation due to the lack of histopathological data. The histopathological findings revealed osteomyelitis or inflammatory spondylitis in all 15 patients: seven patients had acute osteomyelitis and eight patients had chronic osteomyelitis or inflammatory spondylitis. FDG-PET yielded 15 true-positive results. The tracer uptake correlated with the histopathological findings in each case. Bone scintigraphy performed in 11 patients yielded ten true-positive results and one false-negative result. Follow-up carried out on two patients revealed normal or clearly reduced tracer uptake, which correlated with a normalisation of clinical data. In early postoperative follow-up it was impossible to differentiate between postsurgical reactive changes and further infection using FDG-PET. It is concluded that acute and chronic osteomyelitis of the peripheral as well as the central skeleton can be detected using FDG-PET. osteomyelitis can be differentiated from soft tissue infection surrounding the bone. Unlike computed tomography and magnetic resonance imaging, FDG-PET is not affected by metal implants used for fixing fractures. FDG-PET demonstrated promising initial results with respect to treatment monitoring. Nevertheless, in the early postoperative phase FDG-PET seems to be of limited value owing to unspecific tracer uptake.
- - - - - - - - - -
ranking = 0.16666666666667
keywords = fracture
(Clic here for more details about this article)

5/168. A fractured mandible, from initial operation to removal of tantalum mesh. Report of a case.

    Report is made of a case of fracture of the angle of the mandible. Treatment was attempted with the Sampson pericortical bone clamp, but was unsuccessful. Routine use of intraosseous wire led to a localized osteomyelitis, without union of the fracture. Treatment then was made with a particulate marrow graft contained within a tantalum mesh screen. The screen was removed 30 months postoperatively.
- - - - - - - - - -
ranking = 1
keywords = fracture
(Clic here for more details about this article)

6/168. Pyogenic vertebral osteomyelitis presenting as single spinal compression fracture: a case report and review of the literature.

    STUDY DESIGN: A case report of pyogenic vertebral osteomyelitis (PVO) presenting as single collapsed vertebral body without narrowing of the intervertebral disc space, and review of the literature. OBJECTIVE: To describe an unusual case of PVO showing atypical radiological change and call attention to this condition so that others may avoid this diagnostic pitfall. SETTING: japan. methods: A 62-year-old diabetic woman with suspected T12 pathological fracture of malignant spinal tumor and neurological involvement received urgent anterior decompression and spinal reconstruction without biopsy. RESULTS: Anterior decompression and spinal reconstruction was performed, but histological examination of the specimen after surgery unexpectedly revealed PVO. The surgery was followed by therapy with antibiotics for 7 months. A follow-up radiograph at 5 years after surgery revealed that solid consolidation has been achieved. CONCLUSIONS: diagnosis of PVO presenting with single spinal compression fracture is very difficult. Although the finding of the high signal intensity in the lesion equal to or higher than that of the cerebrospinal fluid on T2-weighted MR image seemed to be the most reliable diagnostic modality retrospectively, diagnosis of this type of PVO is impossible without histology. A needle biopsy before surgery is strongly recommended.
- - - - - - - - - -
ranking = 1
keywords = fracture
(Clic here for more details about this article)

7/168. limb salvage of lower-extremity wounds using free gracilis muscle reconstruction.

    An extensive series reviewing the benefits and drawbacks of use of the gracilis muscle in lower-extremity trauma has not previously been collected. In this series of 50 patients, the use of microvascular free transfer of the gracilis muscle for lower-extremity salvage in acute traumatic wounds and posttraumatic chronic wounds is reviewed. In addition, the wound size, injury patterns, problems, and results unique to the use of the gracilis as a donor muscle for lower-extremity reconstruction are identified. In a 7-year period from 1991 to 1998, 50 patients underwent lower-extremity reconstruction using microvascular free gracilis transfer at the University of maryland shock Trauma Center, Johns Hopkins Hospital, and Johns Hopkins Bayview Medical Center. There were 22 patients who underwent reconstruction for coverage of acute lower-extremity traumatic soft-tissue defects associated with open fractures. The majority of patients were victims of high-energy injuries with 91 percent involving motor vehicle or motorcycle accidents, gunshot wounds, or pedestrians struck by vehicles. Ninety-one percent of the injuries were Gustilo type IIIb tibial fractures and 9 percent were Gustilo type IIIc. The mean soft-tissue defect size was 92.2 cm2. Successful limb salvage was achieved in 95 percent of patients. Twenty-eight patients with previous Gustilo type IIIb tibia-fibula fractures presented with posttraumatic chronic wounds characterized by osteomyelitis or deep soft-tissue infection. Successful free-tissue transfer was accomplished in 26 of 28 patients (93 percent). All but one of the patients in this group who underwent successful limb salvage (26 of 27, or 96 percent) are now free of infection. Use of the gracilis muscle as a free-tissue transfer has been shown to be a reliable and predictable tool in lower-extremity reconstruction, with a flap success and limb salvage rate comparable to those in other large studies.
- - - - - - - - - -
ranking = 0.5
keywords = fracture
(Clic here for more details about this article)

8/168. Pyknodysostosis--a report of two cases with a brief review of the literature.

    Pyknodysostosis is a rare sclerosing bone disorder that has an autosomal dominant trait. It is characterized by short stature, brachycephaly, short and stubby fingers, open cranial sutures and fontanelle, and diffuse osteosclerosis, where multiple fractures of long bones and osteomyelitis of the jaw are frequent complications. We present a report of two cases of pyknodysostosis with evidence of long bone fractures and chronic suppurative osteomyelitis of the jaws in one of the cases. Some of the specific oral and radiological findings that are consistent with pyknodysostosis are reported, along with a brief review of the literature.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = fracture
(Clic here for more details about this article)

9/168. Treatment of infection and non-union after bilateral complicated proximal tibial fracture.

    BACKGROUND AND AIMS: Complicated tibial fractures form a great challenge for orthopaedic surgeons. Non-unions and infections are more common in complicated than in closed fractures. In the present study, we describe a patient case treated for non-union combined to chronic osteomyelitis after bilateral open proximal tibial fractures. MATERIAL AND methods: A female patient born in 1946 was multi-traumatised, when a car hit her as a pedestrian. She went through multiple operations of both tibias due to bilateral complicated proximal fractures. Fractures were stabilised at first with internal fixation, which had to be changed to external fixation due to infection of both sides. During the last operative step a commercial bone graft based on hydroxyapatite and bovine type I fibrillar collagen/tricalcium phosphate ceramic (Collagraft) mixed with autogenous bone marrow was applied. RESULTS: Fractures united after 28 (right tibia) and 22 (left tibia) months of follow-up. At the final follow-up visit 55 months after the initial accident patient walked without any aid and showed no signs of an infection. CONCLUSIONS: The use of commercial mixed xeno-/autogenous-bone graft may provide a feasible alternative in complicated chronic non-unions of the tibia even when an infection is present, especially when autogenous bone is not easily available after previous attempts of bone grafting.
- - - - - - - - - -
ranking = 1.3333333333333
keywords = fracture
(Clic here for more details about this article)

10/168. An unusual bilateral pathological fracture.

    An unusual case of a bilateral pathological fracture of the mandible has been presented. The fracture of the right side of the mandible was through an area of bacteroides osteomyelitis and the fracture of the left side of the mandible was through a large cementifying fibroma, which had replaced the left body of the mandible.
- - - - - - - - - -
ranking = 1.1666666666667
keywords = fracture
(Clic here for more details about this article)
| Next ->


Leave a message about 'Osteomyelitis'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.