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Strategies for the analysis of osteitic bone defects at the diaphysis of long bones.

Tiemann AH, Schmidt HG, Braunschweig R, Hofmann GO - Strategies Trauma Limb Reconstr (2009)

Bottom Line: Surgical treatment of the affected bone segments and soft tissue, followed by reconstructive methods, continues to be the main basic therapy.It is often extremely difficult to decide whether the affected bone segment has to be resected, or whether bone continuity can be preserved.The following paper provides strategies and guidance to help guide decisions in this complex and challenging area.

View Article: PubMed Central - PubMed

Affiliation: Funktionsbereich Septische und Rekonstruktive Chirurgie, Klinik für Unfall- und Wiederherstellungschirurgie, BG-Kliniken Bergmannstrost Halle (Saale), Merseburger Str. 165, 06112, Halle, Germany, andreas.tiemann@bergmannstrost.com.

ABSTRACT
Septic diseases of the bone and the immediate surrounding soft tissue, i.e., osteitis, belong to the most alarming findings in recent traumatology and orthopedic surgery. The paramount goal of this therapy is to preserve the stable weight-bearing bones while maintaining a correct axis and proper working muscles and joints, in order to avoid permanent disability in the patient. "State-of-the-art" therapy of osteitis/osteomyelitis therapy has two priorities: eradication of the infection and reconstruction of bone and soft tissue. Surgical treatment of the affected bone segments and soft tissue, followed by reconstructive methods, continues to be the main basic therapy. It is often extremely difficult to decide whether the affected bone segment has to be resected, or whether bone continuity can be preserved. The following paper provides strategies and guidance to help guide decisions in this complex and challenging area.

No MeSH data available.


Related in: MedlinePlus

Devitalized bone. No bleeding of the Haversian canals after elevation of a “bone-chip”. Texture and color similar to ivory
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Fig5: Devitalized bone. No bleeding of the Haversian canals after elevation of a “bone-chip”. Texture and color similar to ivory

Mentions: In cases with optimal and ‘super vital’ surrounding soft tissue, the borderline for the use of the callotaxis may be shifted toward 5 cm. On the other hand, the manner of performance of the cancellous bone plastic is vitally important. Depending on the bone defect’s size and the surrounding soft tissue, it may be necessary to integrate the plastic in multiple steps in order to avoid cancellous bone graft necrosis, which may reactivate the osteitis (Figs. 5, 6, 7). According to the bone bed the average diameter may vary:Fig. 5


Strategies for the analysis of osteitic bone defects at the diaphysis of long bones.

Tiemann AH, Schmidt HG, Braunschweig R, Hofmann GO - Strategies Trauma Limb Reconstr (2009)

Devitalized bone. No bleeding of the Haversian canals after elevation of a “bone-chip”. Texture and color similar to ivory
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2666826&req=5

Fig5: Devitalized bone. No bleeding of the Haversian canals after elevation of a “bone-chip”. Texture and color similar to ivory
Mentions: In cases with optimal and ‘super vital’ surrounding soft tissue, the borderline for the use of the callotaxis may be shifted toward 5 cm. On the other hand, the manner of performance of the cancellous bone plastic is vitally important. Depending on the bone defect’s size and the surrounding soft tissue, it may be necessary to integrate the plastic in multiple steps in order to avoid cancellous bone graft necrosis, which may reactivate the osteitis (Figs. 5, 6, 7). According to the bone bed the average diameter may vary:Fig. 5

Bottom Line: Surgical treatment of the affected bone segments and soft tissue, followed by reconstructive methods, continues to be the main basic therapy.It is often extremely difficult to decide whether the affected bone segment has to be resected, or whether bone continuity can be preserved.The following paper provides strategies and guidance to help guide decisions in this complex and challenging area.

View Article: PubMed Central - PubMed

Affiliation: Funktionsbereich Septische und Rekonstruktive Chirurgie, Klinik für Unfall- und Wiederherstellungschirurgie, BG-Kliniken Bergmannstrost Halle (Saale), Merseburger Str. 165, 06112, Halle, Germany, andreas.tiemann@bergmannstrost.com.

ABSTRACT
Septic diseases of the bone and the immediate surrounding soft tissue, i.e., osteitis, belong to the most alarming findings in recent traumatology and orthopedic surgery. The paramount goal of this therapy is to preserve the stable weight-bearing bones while maintaining a correct axis and proper working muscles and joints, in order to avoid permanent disability in the patient. "State-of-the-art" therapy of osteitis/osteomyelitis therapy has two priorities: eradication of the infection and reconstruction of bone and soft tissue. Surgical treatment of the affected bone segments and soft tissue, followed by reconstructive methods, continues to be the main basic therapy. It is often extremely difficult to decide whether the affected bone segment has to be resected, or whether bone continuity can be preserved. The following paper provides strategies and guidance to help guide decisions in this complex and challenging area.

No MeSH data available.


Related in: MedlinePlus