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Posttraumatic Acute and Chronic Osteomyelitis

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The Poly-Traumatized Patient with Fractures

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Abstract

Posttraumatic infection is a problem that all surgeons see and the unfortunate complication that affects the trauma patient all too often. It has arbitrarily been divided into acute and chronic. The geographical pattern of the bone that develops osteomyelitis determines the type and stage of the infection. The host comorbidities have a negative effect on the outcome, irrespective of the localized involvement. The initial bacterial load, localized soft tissue damage, bone stability, retained necrotic bone, biofilm on metal, and local blood supply are also factors that influence the development of infection. Posttraumatic infection and osteomyelitis require a team approach with plastic surgery and infectious disease closely involved. The team strategy necessitates surgery in the vast majority of cases and requires excision of infected bone, removal of metal if contaminated, soft tissue coverage, bone stability, and postoperative culture-directed antibiotics. If, after the infection has cleared, the bone segment is mechanically unstable or a segmental defect was created, treatment using wire ring fixation, internal fixation, Masquelet technique, and vascularized fibula grafts has a role in the reconstruction.

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Authors and Affiliations

  1. Orthopaedic Surgery, Case Western Reserve, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA

    John K. Sontich MD

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  1. John K. Sontich MD
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Correspondence to John K. Sontich MD .

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Editors and Affiliations

  1. Department of Trauma, Hand, Plastic and Reconstructive Surgery, Aachen Medical Center, Aachen, Germany

    Hans-Christoph Pape

  2. Florida Orthopaedic Institute, Temple Terrace, Florida, USA

    Roy Sanders

  3. Orthopedic Medicine Specialists, Arlington, Texas, USA

    Joseph Borrelli, Jr.

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Sontich, J.K. (2016). Posttraumatic Acute and Chronic Osteomyelitis. In: Pape, HC., Sanders, R., Borrelli, Jr., J. (eds) The Poly-Traumatized Patient with Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47212-5_26

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  • DOI: https://doi.org/10.1007/978-3-662-47212-5_26

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-47211-8

  • Online ISBN: 978-3-662-47212-5

  • eBook Packages: MedicineMedicine (R0)

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