exudates and Osteomyelitis

Infection following grade IIIB open tibial fracture is common. The primary aim of managing this condition is to achieve control of infection before the bone reconstruction procedure is performed. The outcomes for such patients have not been evaluated in the literature. This study was conducted to examine the outcome of a multi-stage procedure for the treatment of infected grade IIIB open tibial fractures.. Between 2004 and 2008, we treated 11 patients with infected grade IIIB open tibial fractures in our unit. The management of infected grade IIIB open tibial fracture comprised three stages, which included serial debridement, wound closure by local flap surgery and bone reconstruction. The margin of resection and the type of bone reconstruction depended on the anatomical location of the disease, the extent of osteomyelitis and patient preference regarding treatment options. Bone reconstruction procedures included bone grafting, plating, interlocking nail, hybrid and monolateral external fixator, and Ilizarov bone transport.. Gram-negative organisms were isolated from all patients. Pseudomonas aeruginosa (P. aeruginosa) (44%) was the most common organism cultured. Infection was resolved in all patients. Nine fractures achieved union, with a mean union time of 15 months. Two patients with P. aeruginosa infection developed non-union of the fracture and refused additional surgery after three years of treatment.. The multi-stage management approach is well-accepted and effective in controlling infection in infected grade IIIB open tibial fractures.

Topics: Adult; Aged; Aged, 80 and over; Debridement; Female; Fracture Fixation; Fractures, Open; Fractures, Ununited; Humans; Ilizarov Technique; Malaysia; Male; Middle Aged; Osteomyelitis; Prospective Studies; Surgical Flaps; Tibial Fractures; Treatment Outcome; Wound Infection

We review 81 cases of acute haematogenous osteomyelitis from 1983 to 1990 to establish current pattern of clinical presentation, modes of treatment and success of therapy. Majority of the patient (70%) presented within a week of symptom and significant number of them came with fever and swelling of the affected limb. Sedimentation rate was found to be raised in all of them. Fifty-four (55%) of them were treated surgically. The average antibiotic time was one week by intravenous administration followed by additional oral therapy for period up to four weeks. Average follow-up was 9 months. Six of them (7.5%) end up with various complication which was believed to be due to delay in getting medical treatment.

Topics: Anti-Bacterial Agents; Bacteremia; Bone and Bones; Child; Child, Preschool; Female; Hospitals; Humans; Malaysia; Male; Osteomyelitis; Retrospective Studies

Neonatal septic arthritis has always been considered as separate from its counterpart in older children. The condition is uncommon but serious. Affected neonates usually survive, but with permanent skeletal deformities. Ten cases of neonatal septic arthritis were diagnosed between January 1989 and December 1993 in the neonatal intensive care units of two referral hospitals in the state of Kelantan, Malaysia. All except one neonate was born prematurely. The mean age of presentation was 15.6 days. Joint swelling (10/10), increased warmth (7/10) and erythema of the overlying skin (7/10) were the common presenting signs. Vague constitutional symptoms preceded the definitive signs of septic arthritis in all cases. The total white cell counts were raised with shift to the left. The knee (60%) was not commonly affected, followed by the hip (13%) and ankle (13%). Three neonates had multiple joint involvement. Coexistence of arthritis with osteomyelitis was observed in seven neonates. The commonest organism isolated was methicillin resistant Staphylococcus aureus (9/10). Needle aspiration was performed in nine neonates and one had incision with drainage. Follow up data was available for five neonates and two of these had skeletal morbidity. Early diagnosis by frequent examination of the joints, prompt treatment and control of nosocomial infection are important for management.

Topics: Age of Onset; Arthritis, Infectious; Comorbidity; Cross Infection; Female; Humans; Infant, Newborn; Intensive Care, Neonatal; Klebsiella Infections; Malaysia; Male; Methicillin Resistance; Osteomyelitis; Retrospective Studies; Risk Factors; Staphylococcal Infections; Staphylococcus aureus

Topics: Animals; Macaca; Macaca nemestrina; Malaysia; Male; Melioidosis; Monkey Diseases; Osteomyelitis

Topics: Adult; Diagnosis, Differential; Female; Humans; Malaysia; Maxillary Neoplasms; Odontogenic Tumors; Osteoma, Osteoid; Osteomyelitis; Radiography

Topics: Ameloblastoma; Cysts; Humans; Jaw; Malaysia; Neoplasms; Osteomyelitis