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Infection control was the main treatment strategy for chronic hematogenous osteomyelitis
Beckles VLL. J Bone Joint Surg (Br). 2010;92(8):1138-1143. doi:10.1302/0301-620X.92BB.23413.
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In their study, British researchers retrospectively reviewed a series of 167 pediatric patients treated for chronic hematogenous osteomyelitis.
Over 4 years, 167 children were treated for chronic hematogenous osteomyelitis at an elective orthopedic hospital in Malawi, according to Verona L. Beckles, BSc, MBBS, MRCS, of Havering and Redbridge University Hospitals, Essex, United Kingdom and colleagues. Median age at presentation was 8 years. During the study period, there were 239 hospital admissions for treatment. One hundred seventeen patients required one admission, 35 patients required two admissions and 15 patients required more than two admissions.
The researchers’ treatment strategy was infection control followed by reconstruction and stabilization. To guide treatment, they used the Beit CURE radiological classification of chronic hematogenous osteomyelitis. At a minimum of 1-year follow-up, no patients had a recurrent infection.
In all, the 167 patients required 350 surgeries, which represented 6.7% of all children’s operations performed at the researchers’ hospital during the study period. One hundred and ten patients required only one procedure, and no patients required more than three. Two patients with chronic calcaneal osteomyelitis underwent below-knee amputations. Staphyloccocus aureus was the most common organism cultured from operative specimens, and the tibia was the most commonly affected bone, the authors wrote.