Paul Rodham1, Michalis Panteli2, James S H Vun3, Paul Harwood4, Peter V Giannoudis5. 1. NIHR Academic Clinical Fellow, Academic Department of Trauma & Orthopaedics, School of Medicine, Leeds General Infirmary, University of Leeds, Clarendon Wing, Level D, Great George Street, Leeds, LS1 3EX, UK. plrodham@doctors.org.uk. 2. Lecturer in Trauma & Orthopaedic Surgery, Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds, UK. 3. Higher Surgical Trainee in Trauma and Orthopaedics, Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds, UK. 4. Consultant Trauma and Orthopaedic Surgeon, Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds, UK. 5. Professor of Trauma and Orthopaedics, Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds, UK.
Abstract
PURPOSE: The aim of this study was to examine the patient-reported outcomes of patients presenting with post-traumatic osteomyelitis (PTOM) of the lower limb over the past 15 years. This period was chosen to reflect modern treatment principles and increased centralisation of care. METHODS: An electronic literature search of the relevant databases (PubMed, Ovid Medline, Embase, and the Cochrane library) was conducted to identify studies published between January 2006 and July 2021 reporting series of greater than 10 patients with PTOM of the tibia or femur at the site of a previous fracture. Studies reporting septic non-union were excluded. RESULTS: Sixteen eligible studies were identified and included in the final report. Remission of infection was achieved in 93.2% of cases (range 70-100%), whilst amputation was reported in 1-7% of cases. A variety of patient-reported outcome measures were utilised including the lower extremity functional scale, short musculoskeletal functional assessment, Enneking score, and EQ-5D-3L. Limb-specific functional outcomes returned to levels similar to that of the general population although poorer outcomes were noted in specific cohorts including those with complex anatomic disease and active medical comorbidities. CONCLUSION: Infection following fracture fixation remains a difficult problem to treat. Regardless, using modern treatments and techniques patients can have comparable functional outcomes to that of the general population. High-quality studies are required to advance our knowledge into which types of treatments offer a benefit and how to further improve outcomes.
PURPOSE: The aim of this study was to examine the patient-reported outcomes of patients presenting with post-traumatic osteomyelitis (PTOM) of the lower limb over the past 15 years. This period was chosen to reflect modern treatment principles and increased centralisation of care. METHODS: An electronic literature search of the relevant databases (PubMed, Ovid Medline, Embase, and the Cochrane library) was conducted to identify studies published between January 2006 and July 2021 reporting series of greater than 10 patients with PTOM of the tibia or femur at the site of a previous fracture. Studies reporting septic non-union were excluded. RESULTS: Sixteen eligible studies were identified and included in the final report. Remission of infection was achieved in 93.2% of cases (range 70-100%), whilst amputation was reported in 1-7% of cases. A variety of patient-reported outcome measures were utilised including the lower extremity functional scale, short musculoskeletal functional assessment, Enneking score, and EQ-5D-3L. Limb-specific functional outcomes returned to levels similar to that of the general population although poorer outcomes were noted in specific cohorts including those with complex anatomic disease and active medical comorbidities. CONCLUSION: Infection following fracture fixation remains a difficult problem to treat. Regardless, using modern treatments and techniques patients can have comparable functional outcomes to that of the general population. High-quality studies are required to advance our knowledge into which types of treatments offer a benefit and how to further improve outcomes.
Authors: Andrew J Hotchen; Maria Dudareva; Ruth A Corrigan; Jamie Y Ferguson; Martin A McNally Journal: Bone Joint J Date: 2020-11 Impact factor: 5.082
Authors: W J Metsemakers; M Morgenstern; M A McNally; T F Moriarty; I McFadyen; M Scarborough; N A Athanasou; P E Ochsner; R Kuehl; M Raschke; O Borens; Z Xie; S Velkes; S Hungerer; S L Kates; C Zalavras; P V Giannoudis; R G Richards; M H J Verhofstad Journal: Injury Date: 2017-08-24 Impact factor: 2.586
Authors: Ian Wilson; Eric Bohm; Anne Lübbeke; Stephen Lyman; Søren Overgaard; Ola Rolfson; Annette W-Dahl; Mark Wilkinson; Michael Dunbar Journal: EFORT Open Rev Date: 2019-06-03
Authors: Elysia A Masters; Ryan P Trombetta; Karen L de Mesy Bentley; Brendan F Boyce; Ann Lindley Gill; Steven R Gill; Kohei Nishitani; Masahiro Ishikawa; Yugo Morita; Hiromu Ito; Sheila N Bello-Irizarry; Mark Ninomiya; James D Brodell; Charles C Lee; Stephanie P Hao; Irvin Oh; Chao Xie; Hani A Awad; John L Daiss; John R Owen; Stephen L Kates; Edward M Schwarz; Gowrishankar Muthukrishnan Journal: Bone Res Date: 2019-07-15 Impact factor: 13.567