Chronic osteomyelitis in Ibadan

Abstract

Chronic osteomyelitis¹ refers to infection of the bone that extends beyond six to eight weeks. The term 'osteo' means bone and 'myelo' means the marrow cavity, both of which are involved in this disease. CO can arise primarily denovo or following acute osteomyelitis in which treatment has been delayed or is inadequate, and this is common among patients with sickle cell anaemia. Secondary chronic osteomyelitis can arise as a complication of open fractures, arthroplasties or following bone injuries². CO can persist for years. The hallmark feature of CO is the presence of infected dead bone, called sequestrum that has separated from living bone. The involucrum is a sheath of new bone which forms around the dead bone. There may be a cloaca which is a sinus through which pus discharges, burrowing through the soft tissues to the skin⁶. There is no medical management of C0³ and treatment is primarily surgical and involves the complete debridement of all devitalised bone and soft tissues regardless of the size of the wound⁴.