Osteomyelitis

Osteomyelitis refers to the inflammation of bone caused by infection. In this condition, bacteria eats away at the bone threatening the limb and sometimes the patient's life.  Below, we see a case involving osteomyelitis and how we deal with this condition.

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Microscopic View Of Infected Bone

osteomyelitis bone pathology

Dead, Infected Bone

osteomyelitis bone pathology

Here we see examples of bone fragments under a microscope.

One of the bone fragments is devoid of living cells and is dead from infection. The other fragment shows living cells within the bone space.

These studies give us a better idea of whether or not osteomyelitis is affecting a bone.

Living Bone

osteomyelitis bone pathology
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Initial Visit

Before coming to our center this patient broke their femur and was treated with a trauma nail.

They developed a bacterial infection and as a result, required two revision surgeries.

The infection persisted forming colonies on and around the nail and spread to the bone, eating away at the femur.

Post-Operative

Dr. Fragomen was able to eradicate the infection, remove the old nail, clean out the dead bone, and insert a new compression nail with antibiotic paste.

The compression nail allows the space between the femur to be strongly squeezed igniting a strong healing response.

A layer of antibiotic paste was applied to the nail to prevent further infection.

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Healing

The femur begins to fully consolidate and is continuously monitored for further signs of infection.

Due to the damage created by the infection, the femur is now shorter than the other side.

Lengthening

In order to achieve equal leg lengths, a femoral osteotomy was performed, and a lengthening nail was inserted. 

A plate was also inserted on the lateral side of the femur to reinforce the bone.

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Recovery

Eventually, the bone consolidated and equal leg lengths were achieved.

Due to the previous infection, the hardware is removed later down the line to ensure no future bacterial resurgence.

Thanks to this novel approach pioneered by Dr. Fragomen, this patient regained the use of their leg and the infection was wiped out.

More Resources:

The PRECICE Magnetic IM Compression Nail For Long Bone Nonunions: A Preliminary Report (Article by Austin T. Fragomen)