Definition

Infection and inflammation of the bone or the bone marrow can be classified as acute or chronic.

Osteomyelitis is a difficult disease that often recurs and may require months or more of treatment. Its pathogenic bacteria stem from the blood circulation or open wounds, and the elderly, people with diabetes or peripheral vascular diseases belong to the potentially dangerous group. The bacteria causing osteomyelitis are mostly pyogenic bacteria. In addition, tuberculosis or fungi can also cause osteomyelitis.

Common Causes

• The bacteria enter the bloodstream and infect bone tissue.
• Soft tissue is then infected with bacteria and transmitted to nearby injured bone tissue.
• Open fractures, orthopedic surgery or other post-traumatic infections.
• After tumor electrotherapy, osteonecrosis and subsequent infection are induced.

Clinical Symptoms

• Acute osteomyelitis

Mild tenderness in affected areas, then fever, chills, limb pain, mobility difficulties, followed by redness, swelling, heat, pain, etc. The most significant clinical symptoms are fever and local bone tenderness that, if not treated properly, can spread to soft tissue abscesses outside the bone.

• Chronic osteomyelitis

It is only an unhealed wound or fistula with persistent purulent secretion or purulence. Sometimes the wound or fistula will be closed automatically, but soon it starts to ooze pus again and again.

• There may be no symptoms in the absence of the attack, but the local skin is darker, and contracture of the adjacent joint is caused by the scar in adjacent tissues. Sometimes when the body's resistance is low, the symptoms of acute osteomyelitis will suddenly recur, such as fever, chills, local swelling, fever, pain, and abscess.

Diagnostic Test

• Hematologic examination:

Increased erythrocyte rates (ESR) indicate inflammation.

• Radiological examination:

Including X-ray examination, computed tomography and magnetic resonance imaging.

• Whole-body bone scan:

It can judge the blood flow of the affected part and the ability of osteoblasts, and indirectly determine whether there is inflammation.

• Bacterial culture:

The main purpose is to select the antibiotics used according to the results of bacterial culture.

• Bone tissue biopsy

Therapy

Surgical debridement and antibiotic therapy are two principles in the treatment of osteomyelitis.

• Surgical treatment: debridement, external skeletal fixation, soft tissue reconstruction, and bone reconstruction.
• Antibiotic therapy: acute osteomyelitis is mainly treated with antibiotics, while chronic osteomyelitis requires surgical debridement and antibiotic therapy.

Home Care

• After discharge, continue muscle exercise 3 to 4 times a day.
• Perform weight-bearing and rehabilitation exercises according to the physician's instructions to prevent muscle atrophy.
• Use appropriate assistive devices as directed.
• Perform wound or external fixator care as directed.
• Diet should be high in protein and vitamins to promote wound healing.
• If the body temperature rises and the wound site appears red, swollen, hot and painful and oozes secretions, it might be an infection. Return to hospital for medical treatment immediately.
• Take medicine and pay a return visit as scheduled.