ePlasty: Vol. 11
Aggressive Management of Tibial Osteomyelitis Shows Good Functional Outcomes
Raewyn Campbell, BMed (Hons), BAppSc (Physio), Grad Dip (Exercise and Sport Science), M. G. Berry, MS, FRCS (Plast), Anand Deva, BSc (Med), MBBS (Hons), MS, FRACS, FASPS, Timothy O'Carrigan, MBBS (Hons), FRACS, FAOrthA, and Ian A. Harris, MBBS, MMed (Clin Epid), PhD, FRACS, FAOrthA

Departments of Plastic and Reconstructive Surgery and Orthopaedic Surgery, Liverpool Hospital and the South Western Clinical School, University of New South Wales, Sydney Australia


Correspondence: raewyn.campbell@gmail.com

Background: Severe open tibial fractures can be successfully treated acutely with a combined orthopedic and plastic surgery approach, but a proportion will go on to develop chronic osteomyelitis. For the past 6 years, an aggressive approach of bone and soft tissue debridement followed by skeletal reconstruction and vascularized tissue transfer has been pursued by the orthopedic and plastic surgery teams at Liverpool Hospital. We present the results of our patient series. Methods: All patients treated for chronic osteomyelitis by combined skeletal stabilization, debridement, and flap coverage between January 2000 and July 2006 were included. Clinical record review was combined with patient interviews and questionnaires. Outcome measures included fracture union, stable soft tissue coverage, freedom from infection, mobility, return to work/sport, and pain. Results: Twelve patients were followed up after a mean of 4.2 years. Patients had undergone a mean of 8.4 procedures prior to treatment, and a .......