• Fistula
• Microorganism profile
• PJI; periprosthetic joint infection
• Sinus tract
• THA; total hip arthroplasty

• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Middle Aged
• Arthroplasty, Replacement, Hip/adverse effects
• Case-Control Studies
• Hip Prosthesis/adverse effects
• Hip Prosthesis/microbiology
• Prosthesis-Related Infections/microbiology
• Retrospective Studies
• Risk Factors

• Clinical manifestations
• Osteomyelitis
• Risk factors
• Tibia

• Humans
• Osteomyelitis/epidemiology
• Osteomyelitis/microbiology
• Osteomyelitis/diagnosis
• Male
• Female
• Retrospective Studies
• Middle Aged
• China/epidemiology
• Adult
• Chronic Disease
• Tibia/microbiology
• Risk Factors
• Aged
• Young Adult
• Adolescent

• (2019E0277) the Xinjiang Uygur Autonomous Region
• (2023D01C93) Natural Science Foundation of Xinjiang Uygur Autonomous Region

• Recurrent osteomyelitis
• bamboo stick injury
• blunt trauma
• rib excision
• ribs

• Antibiotics
• Chronic osteomyelitis
• Debridement
• Osteomyelitis recurrence
• Osteomyelitis relapse

An internal fixation composite structure of antibiotic cement plates was created. The aim of this study was to analyse the infection control effect of this structure when applied to treat a bone infection. We retrospectively analysed patients with bone infection admitted to our hospital between January 2013 and June 2019. After debridement, an antibiotic cement plate composite structure was used to fill and stabilize the defects. The treatment effect was evaluated at six months after surgery, and the infection control rate, factors associated with the recurrence of infection, and complications were analysed. If the patients had bone defects, the defect was repaired after infection control, and the infection control rate of all of the patients was re-evaluated at 12 months after surgery. A total of 548 patients were treated with this technique, including 418 men and 130 women. The infection sites included 309 tibias, 207 femurs, 16 radii and ulnae, 13 humeri, and 3 clavicles. After at least 6 months of follow-up, 92 patients (16.79%) had an infection recurrence and needed further treatment. The recurrence rate of the tibia was higher than that of the femur (P = 0.025). Eighty-nine out of 92 patients who relapsed underwent a second debridement with the same method, and the infection control rate after the second debridement was 94.71%. Complications included 8 cases of epidermal necrosis around the incision, 6 cases of internal fixation failure, and 30 cases of lower limb swelling. By the follow-up time of 12 months, another 6 patients had experienced recurrence of infection, and 4 cases were controlled after debridement. Finally, among all 548 cases, 7 patients remained persistently infected, and 6 underwent amputation. The infection control rate was 97.6% at the 1-year follow-up. The clinical efficacy of this new antibiotic cement plate composite structure for internal fixation after debridement of bone infection is stable and reliable.

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bone Cements/therapeutic use
• Child
• Child, Preschool
• Chronic Disease/therapy
• Curettage/methods
• Curettage/statistics & numerical data
• Female
• Follow-Up Studies
• Foot Bones/microbiology
• Foot Bones/pathology
• Foot Bones/surgery
• Gait/physiology
• Heel/pathology
• Heel/surgery
• Hospitals, University/statistics & numerical data
• Humans
• Leg/pathology
• Leg/surgery
• Leg Bones/microbiology
• Leg Bones/pathology
• Leg Bones/surgery
• Male
• Middle Aged
• Osteomyelitis/complications
• Osteomyelitis/microbiology
• Osteomyelitis/pathology
• Osteomyelitis/surgery
• Pseudarthrosis/microbiology
• Pseudarthrosis/physiopathology
• Pseudarthrosis/surgery
• Plastic Surgery Procedures/methods
• Plastic Surgery Procedures/statistics & numerical data
• Recovery of Function
• Retrospective Studies
• Skin/injuries
• Skin/microbiology
• Skin/pathology
• Treatment Outcome
• Wound Healing
• Young Adult

• children
• infections
• management
• osteomyelitis
• septic arthritis
• sub-Saharan Africa

• Jimma University Institute of Health

• bone graft substitute
• calcium phosphate
• chronic osteomyelitis
• silver-ion

• Posttraumatic osteomyelitis
• Recurrence
• Risk factors;bone transport

Haematogenous osteomyelitis is an extremely rare disease occurring in adults, especially in developed countries. It is clearly a systemic infection, because bacteraemia spreads over proximal and distal long bones or paravertebral plexuses, resulting in acute or chronic bone infection and destruction.

A 46-year-old Caucasian male was complaining of a left thigh pain. It is known from the anamnesis that the patient developed severe pneumonia three months ago before the onset of these symptoms. The patient was diagnosed with haematogenous osteomyelitis, which developed a turbulent course and required complex combination therapy. The primary pathogen is thought to be Anaerococcus prevotii, which caused pneumonia before the onset of signs of osteomyelitis. Unfortunately, due to the complexity of identifying anaerobes and contributing nosocomial infections, the primary pathogen was not extracted immediately. After the manifestation of this disease, pathological fractures occurred in both femurs, as well as purulent processes in the lungs and molars accompanied. The patient received broad-spectrum antibiotic therapy and countless amounts of orthopaedic and reconstructive surgeries, but no positive effect was observed. The patient underwent osteosynthesis using an Ilizarov’s external fixation apparatus, re-fixations, external AO, debridements, intrame-dullary osteosynthesis with a silver-coated intramedullary nail, abscessotomies. The right femur healed completely after the pathological fracture and osteomyelitis did not recur. Left femur could not be saved due to non-healing, knee contracture and bone destruction. After almost three years of struggle, it was decided to amputate the left limb, after which the signs of osteomyelitis no longer appeared.

To sum it all up, complicated or chronic osteomyelitis requires surgery to remove the infected tissue and bone. Osteomyelitis surgery prevents the infection from spreading further or getting even worse up to such condition that amputation is the only option left.

• Hematogenous
• Femur osteomyelitis
• Reciprocal
• Pathologic fracture
• Anaeroccocus prevotii
• Case report

• Bactericidal
• Nanoglass paste
• Osteomyelitis
• Osteopromotive
• Pro-angiogenic
• Therapeutic actions

• infectious diseases
• measurement
• quality
• reimbursement
• value

• Induced membrane technique
• Masquelet technique
• Osteomyelitis
• Pseudomonas aeruginosa
• Recurrence of infection

Osteomyelitis is a difficult-to-cure infection with a high relapse rate despite combined medical and surgical therapies. Some severity factors, duration of antimicrobial therapy and type of surgical procedure might influence osteomyelitis relapse.

116 patients with osteomyelitis were followed for ≥1 year after hospital discharge. Demographic, microbiological and clinical data, eight severity factors and treatment (surgical and antibiotic) were analyzed.

Mean age was 53 years and 74.1% were men. Tibia (62.1%) and S. aureus (58.5%) were the most commonly involved bone and bacteria, respectively. Mean follow-up was 67.1 months. Forty-six patients underwent bone debridement, 61 debridement plus flap coverage and 9 antimicrobial therapy only. Twenty-six patients (22.4%) relapsed, at a mean of 11.2 months since hospital discharge. Duration > 3 months (p = 0.025), number of severity factors (P = 0.02) and absence of surgery (P = 0.004) were associated with osteomyelitis relapse in the univariate analysis. In the Cox regression analysis, osteomyelitis duration > 3 months (P = 0.012), bone exposure (P = 0.0003) and type of surgery (P < 0.0001) were associated with relapse. Regarding the surgical modalities, bone debridement with muscle flap was associated with better osteomyelitis outcomes, as compared with no surgery (P < 0.0001) and debridement only (P = 0.004).

Osteomyelitis extending for > 3 months, bone exposure and treatment other than surgical debridement with muscular flap are risk factors for osteomyelitis relapse.

• Antibiotics
• Debridement
• Muscular flap
• Osteomyelitis
• Relapse
• Severity factors

• combat trauma
• combat-related infections
• trauma-related infections
• wound infections

The current study was designed to explore the epidemiology of extremities chronic osteomyelitis, its prognosis and the complications of the treatment methods being used in southwest China. The data from osteomyelitis patients treated at the Department of Orthopaedics, Southwest Hospital, China between May 2011 and September 2016 were collected and analysed. The study comprised 503 admitted patients, of which 416 males and 87 were females, with an average age of 40.15 ± 5.64 years. Approximately 356 cases were followed for more than 18 months; the average bone union time was 6.24 ± 0.76 months in 94.1% (335) patients, and infections were almost controlled in 93.8% patients. The rate of infection control with the induced membrane technique was higher than with the I-stage free bone graft. Iliac infection was the main complication of the induced membrane technique, and impaired joint activity was the main complication of I-stage free bone grafts. In southwest China, the incidence of haematogenous osteomyelitis, caused mainly by Staphylococcus aureus, remains very high. The speed of bone defect repair and the rate of infection control with the induced membrane technique were superior to those of I-stage free bone grafts. Internal fixation should be given priority because it offers reduced complications with no increase in the recurrence of infection.

• Blood transfusion
• Posttraumatic osteomyelitis
• Pseudomonas aeruginosa
• Recurrence
• Risk factors