Clinical outcome of chronic haematogenous osteomyelitis of the femur or tibia in adults using selective segmental osteotomy and induced membrane technique.

Abstract

Identification of infected lesions in chronic haematogenous osteomyelitis (CHOM) is challenging due to no distinct boundary. The optimal methods of debridement and bone reconstruction remain controversial. The aim of this study was to evaluate the clinical efficacy of selective segmental osteotomy with induced membrane technique in adult CHOM patients of the femur or tibia. The patients who underwent a staged surgery of induced membrane technique were include. In the first stage. the patients were treated by selective segmental osteotomy for debridement according to imaging result preoperatively. In the second stage, spacer removing, fixation and bone grafting were performed sequentially. 16 patients were included. The mean age was 34.7 years. After debridement, the mean bone defects length was 7.9 cm. At a mean followed-up of 30.5 months, no infection recurrence in all patients. At the last follow-up, all patients achieved bone union on average at 6.9 months. Visual Analogue Scale (VAS) score, Self-rated Anxiety Scale (SAS) score, and Hospital for Special Surgery (HSS) score improved at 3 months after the second stage of surgery and at the final follow-up compared with initial admission (P < 0.05). For adult patients with CHOM of femur and tibia, selective segmental osteotomy with induced membrane technique is a feasible and effective treatment method.