NDLI: Modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type

Content Provider	Springer Nature : BioMed Central
Author	Tan, Yanbin Li, Hang Pan, Zhijun Zheng, Qiang
Abstract	Background No standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation. Our team evaluates the clinical efficacy of the modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny–Mader type. Methods Ninety-five wounds were reviewed from March 2009 to February 2016 in our hospital. Sixty-one wounds were treated by the modified algorithm as follows: stable hardware + bone not healed Cierny–Mader 1 type = remove hardware, temporary stabilize; stable hardware + bone not healed Cierny–Mader 2 type = retain hardware ; stable hardware + bone not healed Cierny–Mader for type 3 and type 4 = remove hardware, temporary stabilize/Ilizarov technique; unstable hardware + bone not healed = remove hardware, temporary stabilize/Ilizarov technique; and stable hardware + bone healed = remove hardware. Thirty-four wounds were treated by the conventional algorithm. Autodermoplasty, flap transfer, myocutaneous flap, and other methods including antibiotic irrigation and drug delivery system were used in wound repair. Results The patients treated with modified algorithm had a significantly reduced recurrence (P < 0.01) and increased results of negative bacterial cultures (P < 0.01); however, a decrease in the number of retained hardware cases was observed (P < 0.05). For those treated with tissue reconstruction, there was no significance (P > 0.05) compared with the conventional group. Conclusions The modified algorithm for the postoperative osteomyelitis following fracture fixation according to the stability of the hardware and Cierny–Mader type represents a good clinical efficacy in the management of postoperative osteomyelitis. This procedure is simple and shows promising results; more clinical evidence is needed to confirm the existing findings and optimize the treatment of postoperative osteomyelitis following fracture fixation.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-020-01693-8.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-020-01693-8
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2020-06-09
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Osteomyelitis Postoperation Implant
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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