Bone infection, also known as Osteomyelitis, results when bacteria or fungi invade the bone. Amongst children bone infections most commonly occur in the long bones of the arms and legs. In adults, it usually appear in the hips, spine, and feet.
Bone infections can happen suddenly or develop over a long period of time. If they´re not properly treated, bone infections can leave a bone permanently damaged.
Bone infections leading to Non-Union are very challenging and there is considerable morbidity associated with infected Non-Union.
Many organisms, most commonly staphylococcus, travel through the bloodstream and can cause a bone infection. An infection may begin in one area of the body and spread to the bones via the blood stream.
Organisms that invade a severe injury, deep cut, or wound can also cause infections in nearby bones. Bacteria can enter your system at a surgical site, such as the site of a hip replacement or bone fracture repair. When your bone breaks, bacteria can invade the bone, leading to osteomyelitis.
The most common cause of bone infections is Staphylococcus aureus bacteria. These bacteria commonly appear on the skin but don´t always cause health problems. However, the bacteria can overpower an immune system that´s weakened by disease and illness. These bacteria can also cause infections in injured areas.
In the last decade significant progress has been made in the management of infected Non-Union. There are clear guidelines for pre-operative evaluation and treatment strategy. The recommended strategy is the ´infection-elimination first´ strategy. This strategy involves two steps: control of infection by local radical debridement of dead tissue followed by reconstruction.
There are four operative techniques (with considerable overlap among them) which have been used in the past decade: Ilizarov, intramedullary devices with or without the use of external fixator, free tissue transfer, and reconstruction. Bone results are, in general, better compared to functional results.
Nonsurgical treatment must be examined first when patients have least or no neurological abnormalities and the morbidity and mortality rate of surgical intervention is high. Osteomyelitis is an inflammation of bone tissue and bones can be affected in many ways. Surgery may be indicated if there is massive damage to bone due to osteomyelitis. Surgical treatment may also be undertaken for those who may have a malignant tumor or a badly infected wound that cannot be reduced. However, surgery may be indicated when any of the following situations are present:
Overall, the outcome following treatment of infected Non-Union are good to excellent.