Treatment of chronic osteomyelitis requires removal of all infected, necrotic bone and all metal foreign bodies; debridement of all necrotic soft tissue; and marsupialization of the necrotic, infected bed. Stability…
ETIOLOGY OF EXOGENOUS OSTEOMYELITIS Exogenous (nonhematogenous) osteomyelitis results from the direct contamination of the bone by the infecting organism. The skin, subcutaneous tissue, and periosteum provide a protective barrier to…
Although the many exogenous causes of osteomyelitis vary greatly, the resulting bone infections share some common characteristics. The bone becomes infected because the protective skin and periosteal barriers have been…
Radiographs of the painful area should be obtained, although radiographic signs are often minimal early in the infection. The earliest radiographic evidence of acute hematogenous osteomyelitis is swelling of soft…
ETIOLOGY AND PREVALENCE OF HEMATOGENOUS OSTEOMYELITIS In contrast to direct contamination of the bone from exogenous sources, hematogenous osteomyelitis results when the bone is seeded with bacteria from a distant…
Clinical manifestations of acute hematogenous osteomyelitis of the spine are more difficult to define. The patient may complain of a vague backache as well as generalized malaise, decreased appetite, and…
Except in very young children, the infection rarely extends across the physical barrier of the growth plate. In children younger than 1 year of age, some branches of the metaphyseal…
Direct trauma to the skin overlying the bursa can seed the fluid in an inflamed, swollen bursa with bacteria. The fluid is an excellent medium for bacterial growth, and the…
Peptide and steroid hormones help regulate fracture healing. Growth hormone, insulin, thyroid hormone, cortisol, and gonadal steroids all have important functions throughout the process of fracture healing; each of these…
Clinically, fracture healing is complete when bone strength at the fracture site has been restored to normal and the marrow space is re-formed. This may occur as soon as 6…
