Professional Documents
Culture Documents
Chronic Osteomylitis
Cierney Mader Classification
Medullary Superficial Localized
Diffuse
Chronic Osteomylitis
Cierney Mader Classification Physiological Aspects Host Normal and Healthy Host Immune compromise Local Factors Systemic Factors
1. 2.
Treatment Principles
Antibiotics
Skeletal sabilisation
Fretting
Long Op time and high blood loss
GLYCOCALYX
Membrane surrounding the microbes
DILEMMA
Case scenarios
Infected non union difficult to treat Infection rate high in inadequately fixed fractures
Rigid fixation can further reduce infection rate Presence of one organism can lead to other organisms colonising
Laminar Flow Pre op antibiotics Closed body exhaust suits Tissue handling Antibiotic cement Minimise traffic
Polymicrobes
Investigations
Treatment
To retain or not Patient and disease factors
immunocompromised Virulent bacteris, forming glycoclayx, gram negative bacteria, poor host bed
Treatment..
Single stage versus two stage revisions Gold standard is two stage revisions
Salvage methods
Arthrodesis Resection arthroplasty Amputation Prognosis poor