CONDITIONS

LIMB RECONSTRUCTION

CHRONIC OSTEOMYELITIS

OVERVIEW

Osteomyelitis is a rare but serious infection of the bone. Osteomyelitis causes inflammation of the bone and bone marrow. It occurs when fungi or bacteria enter the bloodstream and enter the bone through an injury or surgical site. Usually white blood cells will attack the foreign bacteria, however, if the infection withstands the immune system's efforts to fight it, an abscess may form in the bone, blocking the blood supply leading to chronic osteomyelitis. The risk of bone death then increases.

CAUSE

Osteomyelitis is commonly caused by a type of staph bacteria which enters the bone. An infection in the bloodstream, complications of trauma or surgery, or pre-existing conditions, such as diabetes may increase the risks of developing a bone infection.

SYMPTOMS

Depending on the severity of the infection, symptoms of chronic osteomyelitis may include:

  • Severe pain in the area
  • Swelling, redness and tenderness in the area
  • Fever, chills and sweating
  • Irritability
  • Fatigue
  • Pussing from an open wound near the affected area

TREATMENT

Treatment depends on the type of osteomyelitis. In acute cases, the bone infection develops within 2 weeks of the injury, and antibiotic treatment is usually the first course of action. Sometimes surgery is necessary to small drill holes in the bone to drain the infection. Antibiotics is given over long period of 4 to 6-weeks of intravenous antibiotics in the hospital or in some cases, on an outpatient basis.

When acute infections of the bone are not treated, an abscess may form which can affect the blood supply to the bone and cause eventual bone death. Chronic osteomyelitis thus includes the recurrence of pain, swelling and drainage despite antibiotic treatment.

In such cases, hospitalised intravenous antibiotics and surgical debridement of necrotic bone is the primary treatment. In some cases, antibiotics may be directly delivered to the affected bone through implantable pumps. Surgery is needed to remove bone damage and may involve drainage of pus, debridement of diseased bone and bone grafting to restore blood flow to the bone tissue. If internal fixation was previously done, these foreign bodies are removed, and external fixation is used to stabilise the bone. Depending on the severity of the infection, suction vacuum devices, skin grafts and muscle flaps may also be necessary.

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