Chronic osteomyelitis of the long bones

Abstract

Background: Chronic osteomyelitis is a challenging condition both to the clinician and the patient. Despite the advances that have been made in the areas of antibiotic management and operative treatment, the condition is still associated with high incidence of recurrence and high morbidity rate.

Objective: The aim of the study is to review the incidence, pattern, clinical features and outcome of the treatment of chronic osteomyelitis of the long bones in a tertiary Hospital in South-Eastern Nigeria.

Methodology: The study was conducted in a tertiary health centre located in a sub-urban area in the South–Eastern region of Nigeria. It was retrospective in nature and involved consecutive patients who presented to the hospital with chronic osteomyelitis of any of the long bones over a two year period. Clinical data were obtained from the hospital records and analyzed.

Results: A total of 57 patients were recruited in the study, with a male to female ratio of 1.7:1. The mean age at presentation was 35.6 years (range: 3-80 years). Osteomyelitis was most common in the first and second decades of life (42%). Trauma was the most common cause of osteomyelitis (65%), of which road vehicle crashes accounted for 54% of cases. Out of these, 67.6% were due to open injuries. The most common bone affected was the tibia (44%), while the least affected bone was the radius (7%). Sixty-nine percent of the patients presented to the hospital at least 12 months after the onset of the problem, while the most common isolated micro-organism was Staphylococcus aureus (38.6%). The cure rate for chronic osteomyelitis was 90.7%.

Conclusion: From this study, chronic osteomyelitis of the long bones was mostly caused by open fractures resulting from motor vehicular crashes, and predominantly affects the tibia. The most frequently isolated pathogenic organism was Staph. aureus. Most of the patients had eradication of the infection following appropriate treatment.

Keywords: Osseous infection, Trauma, South-East Nigeria, Tibia, Staphylococcus aureus