Management of Chronic Osteomyelitis by an Orthoplastic Team: 7-Year Experience of a University Hospital
Autor: | Yaniss Belaroussi, Frédéric-Antoine Dauchy, Thierry Fabre, Grégoire Chadefaux, Chloé Tierny, Vincent Casoli, Anaïs Delgove |
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Přispěvatelé: | Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
Rok vydání: | 2021 |
Předmět: |
Male
Heel medicine.medical_treatment 030230 surgery Curettage Hospitals University 0302 clinical medicine Medicine Leg Bones Child Gait Skin Aged 80 and over Bone Cements Osteomyelitis Middle Aged University hospital 3. Good health Pseudarthrosis medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Child Preschool Female Adult medicine.medical_specialty Adolescent Free flap 03 medical and health sciences Young Adult Humans Aged Retrospective Studies Leg Wound Healing business.industry Foot Bones Recovery of Function Plastic Surgery Procedures medicine.disease Surgery Chronic osteomyelitis Orthopedic surgery Chronic Disease [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business Follow-Up Studies |
Zdroj: | Plastic and Reconstructive Surgery Plastic and Reconstructive Surgery, Lippincott, Williams & Wilkins, 2021, 148 (2), pp.443-453. ⟨10.1097/prs.0000000000008175⟩ |
ISSN: | 1529-4242 0032-1052 |
DOI: | 10.1097/prs.0000000000008175⟩ |
Popis: | BACKGROUND: Treating chronic osteomyelitis of the lower extremities is challenging. The treatment of acute lower limb trauma by orthoplastic teams has shown good results over the past few decades. This study aimed to characterize surgical outcomes of leg and heel chronic osteomyelitis by an orthoplastic team. METHODS: The cases of 113 consecutive leg and heel chronic osteomyelitis patients undergoing soft-tissue reconstruction with an orthopedic procedure were reviewed in this retrospective single-center observational study. The main objective was to assess surgical outcomes of skin healing and gait recovery at the 1-year follow-up. The secondary objective was to evaluate the global success rate at the last follow-up. RESULTS: The median follow-up was 19.7 months. A free flap was performed for 33 patients (29.2 percent) and a locoregional flap was used in 79 patients (69.9 percent). Seventy-two patients (63.7 percent) had chronic osteomyelitis on continuous bone. The others had a septic pseudarthrosis with a mean bone defect length of 42.9 mm. Forty-four patients (38.9 percent) underwent curettage only, eight (7.1 percent) underwent curettage and cement, 20 (17.7 percent) underwent curettage and bone fixation, and 39 (34.5 percent) underwent the Masquelet technique. At the 1-year follow-up, 72 patients (63.7 percent) had achieved skin healing and had recovered their gait. The success rate at all follow-up time points was 82.3 percent. The median time to achieve skin healing was 6.5 months and that to bone union in cases of septic pseudarthrosis was 7.9 months. CONCLUSION: Orthoplastic management of leg and heel chronic osteomyelitis patients with combined soft-tissue reconstruction using an orthopedic procedure was a viable strategy that offered good results even though the time to complete healing was long. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III. |
Databáze: | OpenAIRE |
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