Treatment of femoral defective osteomyelitis with minimal in
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Highlights
-Minimal invasive plating can reduce external fixator duration in treatment of defective femur osteomyelitis.

-Minimal invasive plating reduces relapse of infection in treatment of defective femur osteomyelitis.

-In treatment of defective femur osteomyelitis stepped treatment could be a favourable option.

Although recent treatment modalities reduced chronic osteomyelitis, it is still a challenging problem for both orthopaedic surgeons and patients. Especially treatment of femoral osteomyelitis with defective nonunion is reasonably difficult. In this study, author described a method for reconstruction of infected femoral defective nonunions using minimal invasive plates.

Five patients at an average age of 48.4 (40–61) were included in the study. All of the nonunions were chronic and septic. Stepped surgery was planned at the beginning of the treatment. At the first step, radical debridement was performed and all external or internal implants were removed. Bone was resected up to a healthy level. All necrotic soft tissues and sinus tracts were debrided. Samples for microbiologic examination were taken. After debridement, monolateral external fixator was performed. Acute or gradual compression was made. After regression of signs of infection; at the second stage, an osteotomy was performed and gradual distraction for osteoneogenesis was started. When defect was reconstructed, signs of consolidation waited at the docking site. After the appearance of consolidation signs, the third step was planned. In the third step, a temporary external fixator was performed from the anterior site. Then the lateral external fixator was removed, pin sites were debrided. From openings of these incisions, a locking plate was applied to advance submusculary. In the follow-up controls x rays were taken and clinical scores were noted.

From the story its concluded that to reduce external fixator time and patient discomfort, additional plate placement is a good option for treatment of defective femur septic nonunions. The sterilization techniques and effective antibiotics treatment have made progress recently to both prevent and treat the infection. However, individual armament and wars have progressed similarly. Therefore, even though it is not frequent as before, osteomyelitis would continue to be a major issue for surgeons. For this reason, osteomyelitis treatment requires new surgical techniques and different perspectives.

Source: https://www.sciencedirect.com/science/article/pii/S2352644020300418
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