Dataset Information

Internal fixation of delayed union of fracture with chronic osteomyelitis due to Staphylococcus epidermidis: A case report.

ABSTRACT:

Introduction

The most feared and challenging complication in treating patients with musculoskeletal trauma is infection after fracture fixation, which can delay healing and, in turn, result in permanent functional loss of limbs or even amputation.

Case presentation

Here, we describe a case in which a patient presented with stage 4 chronic osteomyelitis on the right tibia and fibula. To treat the late infection by eradicating or reducing the infection, it was recommended to replace the internal fixation with surgical debridement for 6 weeks and antibiotics for 6-12 weeks until the internal fixation device could be removed.

Conclusion

Delayed union and chronic osteomyelitis are possible complications of IAFF.

SUBMITTER: Munir MA

PROVIDER: S-EPMC7305371 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Internal fixation of delayed union of fracture with chronic osteomyelitis due to Staphylococcus epidermidis: A case report.

Munir Muhammad Ardi MA Tandiabang Pascal Adventra PA Prihantono

Annals of medicine and surgery (2012) 20200611

<h4>Introduction</h4>The most feared and challenging complication in treating patients with musculoskeletal trauma is infection after fracture fixation, which can delay healing and, in turn, result in permanent functional loss of limbs or even amputation.<h4>Case presentation</h4>Here, we describe a case in which a patient presented with stage 4 chronic osteomyelitis on the right tibia and fibula. To treat the late infection by eradicating or reducing the infection, it was recommended to replace ...[more]

PMID: 32577232

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Project description:BackgroundFractures of the femoral shaft are common and have potentially serious consequences in patients with multiple injuries. The appropriate timing of fracture repair is controversial. The purpose of the present study was to assess the effect of timing of internal fixation on mortality in patients with multisystem trauma.MethodsWe performed a retrospective cohort study with use of data from public and private trauma centers throughout the United States that were reported to the National Trauma Data Bank (version 5.0 for 2000 through 2004). The study included 3069 patients with multisystem trauma (Injury Severity Score, > or =15) who underwent internal fixation of a femoral shaft fracture. The time to treatment was defined in categories as the time from admission to internal fixation: t(0) (twelve hours or less), t(1) (more than twelve hours to twenty-four hours), t(2) (more than twenty-four hours to forty-eight hours), t(3) (more than forty-eight hours to 120 hours), and t(4) (more than 120 hours). The relative risk of in-hospital mortality when the four later periods were compared with the earliest one was estimated with inverse probability of treatment-weighted analysis. Subgroups with serious head or neck, chest, abdominal, and additional extremity injury were investigated.ResultsWhen compared with that during the first twelve hours after admission, the estimated mortality risk was significantly lower in three time categories: t(1) (relative risk, 0.45; 95% confidence interval, 0.15 to 0.98; p = 0.03), t(3) (relative risk, 0.58; 95% confidence interval, 0.28 to 0.93; p = 0.03), and t(4) (relative risk, 0.43; 95% confidence interval, 0.10 to 0.94; p = 0.03). Patients with serious abdominal trauma (Abbreviated Injury Score, > or =3) experienced the greatest benefit from a delay of internal fixation beyond twelve hours (relative risk, 0.82 [95% confidence interval, 0.54 to 1.35] for patients with an Abbreviated Injury Score of <3, compared with 0.36 [95% confidence interval, 0.13 to 0.87] for those with an Abbreviated Injury Score of > or =3) (p value for effect modification, 0.09).ConclusionsDelayed repair of femoral shaft fracture beyond twelve hours in patients with multisystem trauma, which may allow time for appropriate resuscitation, reduces mortality by approximately 50%. Patients with serious abdominal injury benefit most from delayed treatment. These results support delaying definitive treatment of long-bone injuries in patients with multisystem trauma as a means of so-called damage-control in order to reduce adverse outcomes.

Dataset Information

Internal fixation of delayed union of fracture with chronic osteomyelitis due to Staphylococcus epidermidis: A case report.

Introduction

Case presentation

Conclusion

Publications

Internal fixation of delayed union of fracture with chronic osteomyelitis due to Staphylococcus epidermidis: A case report.

Similar Datasets

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