Osteomyelitis is infection of bone in clinical terminology. Orthopaedician’s worst nightmare, bone infections are very notorious and difficult to treat. However, over the years, the surgical management of the osteomyelitis has evolved significantly, making it an area of huge scope and interest in the world of modern day orthopaedics.

Pre operative details

8 year old male with history of fall down (trauma) presented with open discharging sinuses over the uknar aspect of the forearm. The patient had previously undergobe multiple debridement surgeries before this particular presentation

Pre operative x-ray

AIMS AND OBJECTIVES

Aim- ok now and understand the management principles of chronic ulna osteomyelitis, in paediatric age group, with discharging sinuses.

Objectives - to assess the functional outcome, clinical outcome, radiological outcome of the surgeries performed. To improve the quality of life of the patient

Method, management, intraoperative findings and post operative details

Ulna sequestrectomy, resection of infected bone, antibiotic cement with k WIRE

Intra-operative picture

Infected bone completely removed

Fibula bone grafting to replace the bone loss, after the patient presented with failure of the previous surgery

Fibula bone grafting with square nail

Intraoperative pictures:

14 months follow up x-ray since the first surgery

Functional outcome

Patient was able to perform routine activities, and do most of the routine work like writing, eating etc.

Elbow extension

Elbow extension

Elbow flexion

Elbow flexion

CONCLUSION

The proposed line of management is a good and efficient modality for the management of osteomyelitis, and can be

Looked upon as a go to method for similar cases in near future

RESULT AND DISCUSSION

There was good clinical recovery, with reasonably good range of motion of the elbow joint of the affected limb, with patient able to do the routine activities of life.

REFERENCES

1. Lew DP, Waldvogel FA. Osteomyelitis. Lancet. 2004;364(9431):369–379.
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3. Calhoun JH, Manring MM, Shirtliff M. Osteomyelitis of the long bones. Semin Plast Surg. 2009;23(2):59–72.
4. Canale ST, Beaty JH. Osteomyelitis. In: Campbell’s Operative Orthopaedics. 13th ed. Philadelphia: Elsevier; 2017. p. 725–760.
5. Masquelet AC, Begue T. The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am. 2010;41(1):27–37.