Keywords : Debridement
Limited Intra-Medullary Debridement With Medulloscopy And Irrigation-Drainage System for Management of Chronic Osteomyelitis Of Long Bones
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 6, Pages 1273-1278
Introduction-Chronic osteomyelitis is a therapeutic challenge and even with proper management it is seldom cured. The usual surgical management involves extensive surgery and prolonged hospitalisation. In cases where only intramedullary variety of infection is present, we can proceed with a less debilitating procedure. In this study our aim is to prove the efficacy of limited intramedullary reaming and medulloscopy with post operative suction-irrigation for managing this kind of osteomyelitis.
Methods and Materials - This study was conducted since June 2018 to May 2020 in which we operated nine patients of medullary chronic osteomyelitis with our technique. The inclusion criteria is Patients with Radiographic / MRI proven Chronic osteomyelitis of medullary variety of Femur or Tibia. Entry points were made at proximal and distal ends of lesion in the bone. The medullary cavity was reamed from proximal and distal points using hand reamers. An arthroscope was used to visualise the medullary cavity for remaining infectious nidus. Post operatively a continuous suction-irrigation system was placed.
Results- Eight patients were followed up for a mean duration of 13 months. At final follow up all the patients were free of symptoms without any pain and discharging sinus.The mean ESR and CRP levels at the time of presentation was 28 and 5.67 respectively and at the final followup was 12 and 0.60 respectively.
Conclusion- Intramedullary debridement using a reamer and arthroscope gives good results as a single staged procedure. With addition of suction-irrigation system it clears off any remaining nidus of infection.