Intramedullary reaming and soft tissue procedures in treatment of chronic osteomyelitis of long bones.

Forty patients suffering from chronic osteomyelitis were treated by intramedullary reaming at the authors' clinic from 1985 to 1991. The patients were divided into two groups according to follow-up time. The observation period averaged 4.4 years in the intermediate-term group and 1.7 years in the short-term group. Four patients suffered a recurrence. Special attention was given to plastic surgical procedures involving intramedullary reaming. Techniques and results of 7 fasciocutaneous flaps, 1 pedicled gastrocnemius muscle flap, and 1 free microvascular rectus abdominis muscle flap are reported. Intramedullary reaming is recommended as a valuable method in the treatment of long-term chronic osteomyelitis. Primary soft tissue grafting with the objective of providing total wound coverage with all available means seems to be the most advantageous method of achieving primary wound healing and avoiding reinfection.