THERAPY OF CHRONIC TIBIA OSTEOMYELITIS BY USING TEMPORARY ANTIBIOTIC SPACER, ROTATORY MUSCLE LOBE, LARVAL THERAPY AND SPONGIOPLASTY WITH PEROSSAL- CASE REPORT


Authors: Eva Čurlejová 1;  Miroslav Homza 1;  Igor Čižmář 1;  Pavel Dráč 1;  Milan Kamínek 2
Authors‘ workplace: Traumatologické oddělení FN Olomouc Department of Trauma surgery, Faculty Hospital Olomouc 1;  Klinika nukleární medicíny FN Olomouc Department of Nuclear medicine, Faculty Hospital Olomouc 2
Published in: Úraz chir. 22., 2014, č.1
Category: Case report

Overview

PURPOSE:
The aim of this work was to introduce diagnostic and surgical process in therapy of chronic tibia osteomyelitis.

MATERIAL AND METHODS:
The authors describe diagnostic and surgical intervention in 55 years old patient with chronic tibia osteomyelitis after plate ostheosynthesis. In setting of the diagnosis they used 18 F- fluorodeoxyglucose PET/ CT and SPECT / CT with marked leukocytes Le-Tc-HMPAO. In therapy they performed radical surgical debridement, lavage and they applied antibiotic spacer in whole medullar cavity of damaged bone. After that they applied the spongioplasty with hydroxyapatite bone replacement PerOssal. Defects of the soft tissues were primary closed by V.A.C. Subsequently they were covered with rotatory muscle lobe. The necrectomy was performed by using larvae Lucillia sericata/green.

RESULTS:
Patient is now without any problems 19 months after the procedure, without any signs of recurrent infection. Patient is able to burden fully his limb and the range of motion (ROM) in knee joint is without any restrictions.

CONCLUSION:
Described surgical procedure represetns one of the therapeutic possibilites of chronic osteomyelitis.

KEY WORDS:
Antibiotic-loaded bone substitute, chronic osteomyelitis, larval therapy, muscle flap, tibia.


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Labels
Surgery Traumatology Trauma surgery
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