Chronic pyogenic osteomyelitis of long bones at specialized hospital in Nigeria

Abstract

Introduction: Chronic pyogenic osteomyelitis of long bones is common and difficult to treat.
Objectives: The aim of this study was to examine the pattern of presentation and outcome of treatment of chronic osteomyelitis of long bones at specialized hospital in Nigeria.
Patients and methods: Case records of patients who were managed for chronic osteomyelitis between January 2009 and December 2011 at Nongu u Kristu u I Ser u sha Tar (NKST) Rehabilitation Hospital, Mkar, were retrieved from the Medical Records Department and analyzed retrospectively for age, gender, bones involved, microbiological isolates, treatment modalities and recurrence.
Results: Fifty-three patients with chronic pyogenic osteomyelitis of 57 long bones were studied. This consisted of 30 males (56.6%) and 27 females (43.4%) giving a male-to-female ratio of 1.1:1.The age range was 3 – 60 years (mean 20.34±13.48). Poorly-treated or neglected acute haematogenous osteomyelitis was the predominamt cause of chronic osteomyelitis (n=40, 70.2%). The involved bones include tibia (n=29, 50.9%), femur (n=11, 19.3%), humerus (n=9, 15.8%). Staphylococcus aureus was the most common offending organism isolated (n=13, 52%).
Sequestrectomy and curettage (n=51, 96.2%) was the main surgical procedure carried out.
Conclusion: Chronic osteomyelitis is mostly a disease of children and predominantly affects the tibia. Poorly-treated or neglected acute  haematogenous osteomyelitis is the predominant cause of the disease.

Keywords: Chronic osteomyelitis, Pattern, Causes.