Modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type.

Journal of Orthopaedic Surgery and Research
Yanbin TanQiang Zheng

Abstract

No standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation. Our team evaluates the clinical efficacy of the modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type. Ninety-five wounds were reviewed from March 2009 to February 2016 in our hospital. Sixty-one wounds were treated by the modified algorithm as follows: stable hardware + bone not healed Cierny-Mader 1 type = remove hardware, temporary stabilize; stable hardware + bone not healed Cierny-Mader 2 type = retain hardware ; stable hardware + bone not healed Cierny-Mader for type 3 and type 4 = remove hardware, temporary stabilize/Ilizarov technique; unstable hardware + bone not healed = remove hardware, temporary stabilize/Ilizarov technique; and stable hardware + bone healed = remove hardware. Thirty-four wounds were treated by the conventional algorithm. Autodermoplasty, flap transfer, myocutaneous flap, and other methods including antibiotic irrigation and drug delivery system were used in wound repair. The patients treated with modified algorithm had a significantly reduced recurrence (P < 0.01) and increased results of negative bacterial cultures (P < 0....Continue Reading

References

Feb 1, 1992·Pathology, Research and Practice·E Böhm, C Josten
Sep 11, 2003·Clinical Orthopaedics and Related Research·George CiernyJohan J Penninck
Jul 28, 2004·Lancet·Daniel P Lew, Francis A Waldvogel
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Jul 13, 2007·The Journal of Trauma·Bruce H Ziran
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Jun 27, 2012·Clinics in Plastic Surgery·Kunj K DesaiEdward Lee
Sep 4, 2012·The Journal of the American Academy of Orthopaedic Surgeons·Philipp N StreubelWilliam T Obremskey
May 21, 2015·World Journal of Orthopedics·Marco MeloniLuigi Uccioli
Jul 2, 2015·Journal of Orthopaedic Trauma·Laura A SchemitschMichael D McKee
Nov 20, 2015·Journal of Orthopaedic Trauma·Gillian E CookEmil H Schemitsch

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