Τίτλος:
Factors associated with adverse postoperative outcomes in patients with long bone post-traumatic osteomyelitis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aims: To evaluate short-term clinical and functional outcomes following operative treatment of long bone post-traumatic osteomyelitis (PTOM). Methods: We retrospectively analyzed a consecutive cohort of 142 adult patients undergoing operative treatment of long bone PTOM at our Level I trauma center over a 10-year study period. In addition to subjective patient evaluations, surveyed postoperative outcomes included incidence of residual infection, fracture malunion or nonunion, and requirement for limb amputation. All included patients had a minimum follow-up of 12 months postoperatively. Results: Patients suffering an adverse postoperative outcome tended to have a higher incidence of polymicrobial infection (25.4 vs. 11.4%, p = 0.042) and requirement for skin grafting (58.1 vs. 37.9%, p = 0.024) and free-flap procedures (43.6 vs. 19.5%, p = 0.003) compared to those achieving complete healing. Sequential administration of parenteral and oral antibiotic therapies was associated with a reduced incidence of adverse postoperative outcome (p = 0.047). Discussion: Patients with long bone PTOM and extensive soft tissue defects often fail to develop complete remission of their symptoms by 12 months postoperatively. Sequential administration of parenteral and oral antibiotics may help to limit infection recurrence. Further research is required to inform optimal treatment strategy. © 2017, Springer-Verlag France.
Συγγραφείς:
Chadayammuri, V.
Herbert, B.
Hao, J.
Mavrogenis, A.
Quispe, J.C.
Kim, J.W.
Young, H.
Hake, M.
Mauffrey, C.
Περιοδικό:
EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY
Εκδότης:
Springer-Verlag France
Λέξεις-κλειδιά:
antibiotic agent; antiinfective agent, adult; adverse outcome; antibiotic therapy; Article; below knee amputation; bone transplantation; female; follow up; fracture external fixation; fracture fixation; fracture nonunion; free tissue graft; human; major clinical study; male; mixed infection; muscle flap; osteomyelitis; osteosynthesis; postoperative infection; posttraumatic osteomyelitis; priority journal; recurrent infection; retrospective study; skin transplantation; soft tissue defect; vacuum assisted closure; wound dehiscence; amputation; bacterial infection; complication; femur fracture; fibula; fracture; fracture nonunion; humerus fracture; injuries; middle aged; mycosis; osteomyelitis; physiology; postoperative complication; procedures; radius fracture; recurrent disease; statistics and numerical data; surgical infection; tibia fracture; treatment outcome; ulna fracture; wound healing, Amputation; Anti-Bacterial Agents; Bacterial Infections; Bone Transplantation; Female; Femoral Fractures; Fibula; Fracture Fixation; Fractures, Bone; Fractures, Malunited; Fractures, Ununited; Humans; Humeral Fractures; Male; Middle Aged; Mycoses; Osteomyelitis; Postoperative Complications; Radius Fractures; Recurrence; Retrospective Studies; Surgical Wound Infection; Tibial Fractures; Treatment Outcome; Ulna Fractures; Wound Healing
DOI:
10.1007/s00590-017-1962-4
