Management of chronic osteomyelitis of the femur and tibia: a scoping review.

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Abstract

Conflict of interest statement: ICMJE Conflict of interest statement: The authors declare no conflict of interest relevant to this work. 4. Plast Reconstr Surg. 2011 Jan;127 Suppl 1:190S-204S. doi: 10.1097/PRS.0b013e3182025070. Surgical treatment of osteomyelitis. Cierny G 3rd(1). Author information: (1)San Diego, Calif. From REOrthopaedics, Inc., and the Center for Specialty Medicine: Musculoskeletal Infection. Chronic osteomyelitis is refractory to nonsurgical treatment due to a resilient, infective nidus that harbors sessile, matrix-protected pathogens bound to substrate surfaces within the wound. Curative treatment mandates physical (surgical) removal of the biofilm colony, adjunctive use of antibiotics to eliminate residual phenotypes, and efforts to optimize the host response throughout therapy. Patient selection, therapeutic options, and the treatment format are determined by the Cierny/Mader staging system, while reconstruction is governed by the integrity/stability of the affected bone(s) and quality/quantity parameters of the soft-tissue envelope. DOI: 10.1097/PRS.0b013e3182025070