SURGICAL TREATMENT OF CHRONIC RECURRENT HEMATOGENOUS OSTEOMYELITIS
DOI:
https://doi.org/10.11603/1811-2471.2019.v.i3.10441Keywords:
chronic recurrent hematogenous osteomyelitis, surgical treatment, sequesternecrectomy local and extendedAbstract
SUMMARY. According to the WHO data, the acute hematogenous osteomyelitis becomes chronic in 20–60 % of patients.
The aim – to improve the results of surgical treatment of chronic recurrent hematogenous osteomyelitis (CRHO) by optimizing the surgical intervention.
Material and Methods. 180 patients with CRHO were involved (from 1995 to 2016), average age was (15.5±5.9) years, the ratio of boys and girls was 2.3/1. The duration of disease in 63.3 % of patients exceeded 4 years, including 12.8 % – 10 years. All patients were divided into two clinical groups: the control group consisted of 74 (41.1 %) – patients who received traditional surgical treatment from 1995 to 2003 (local sequesternecrectomy in the zone of greatest lesion). The basic group of patients consisted of 106 (58.9 %) patients who underwent surgical treatment in the period from 2004 to 2016 according to the developed methodology (a technique of extended sequesternecrectomy with recanalization of the affected bone).
Results. The proposed tactics of surgical treatment of CRHO allowed to statistically significantly reduce the frequency of wound purulent complications from 20.3 to 3.8 %, reduce the overall duration of inpatient treatment (from (31.2±2.1) to (21.9±0.6) days) and the duration of stay in the clinic in the postoperative period (from (18.3±0.9) to (14.9±0.35). Special questionnaire for assessment of the distant results of surgical treatment of CRHO, demonstrated good results in the main group in 97.7 %, in the control group – only in 34.7 % of cases. A satisfactory result in the basic group was in 1 (1.2 %) patient, while in the control group there were 32.7 %. The number of unsatisfactory results in the basic group was significantly lower (1.2 %) than in the control group (32.7 %).
Conclusions. Comparative analysis of the outcomes of CRHO treatment showed that the developed tactics of surgical treatment allowed reducing the recurrence rate of the disease from 32.7 % to 1.2 % and in 98.9 % of patients getting good and satisfactory results.
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