Abstract
We prospectively studied 25 cases of chom (15 femora and 10 tibia). There were 24 males and one female, with the mean age being 33 years (range, 21–58 years). All patients had radiological evidence of chronic osteomyelitis with osteolysis, cortical thinning, sequestration, involucrum, and both medullary and soft tissue swelling. All patients had culture-documented chronic osteomyelitis. The clinical records, radiographs, bone repair, sedimentation rate, and functional outcome using the Enneking/Musculoskeletal Tumor Society System were evaluated.5 ACIIN was used in all cases after adequate debridement. Patients were classified according to the amount of bone defect present after debridement. Infection control was judged on the basis of discharge through the wound and laboratory parameters. All patients were followed-up, with an average follow-up time of 32 months (range, 18–40 months). The mean duration of retention of the intramedullary rod was 8 weeks (range, 6–12 weeks).
The mean preoperative sedimentation rate was 43 mm (range 22 to 105). The local antibiotic used was gentamycin (18 patients) and gentamycin plus vancomycin (7 patient). The mean follow-up was 32 months (range 18 to 40). The mean sedimentation rate at most recent followup was 10 mm. The defect size at most recent followup was 2.1cc, thus making the bone repair 89%. The mean functional score at follow-up was 27 out of 30 points. The one patient with a mixed infection ended up with a functional score of 20. This patient scored 3 points for pain, 3 points for function, 2 points for emotional acceptance and 2 points for gait. There were no fractures, infection relapses, or additional surgery to date.
ACIINs are useful for infection control in cases of chom of long bones
