[One-stage compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone for the treatment of chronic calcaneal osteomyelitis].

Abstract

OBJECTIVE:

To explore the treatment of chronic calcaneal osteomyelitis with bone defect after debridement and evaluate its clinical outcomes.

METHODS:

From June 2009 to June 2011, 52 patients with chronic calcaneal osteomyelitis were treated with stage-one compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone,including 12 females and 40 males with an average age of 43 years old ranging from 18 to 67. According to Cierny-Mader classification, there were 34 cases with stage III and 18 with stage IV. There were 32 cases on right side and 20 on left,with a course of 6 months to 3 years. The area of soft tissue wound ranged from 3.0 cm x l.5 cm to 23.0 cm x l2.0 cm. The clinical effects were evaluated according to infection controlling, calcium sulfate absorption,bone defect repair and heel functional recovery.

RESULTS:

All patients were followed up for 2 to 3.8 years (averaged 2.8 years). Primary healing was achieved in 52 patients. Two cases of recurrence were found post-operatively, 1 case in 3 months and another in 5 months,which were cured after a second operation. Bone repair healing was gained in 1.5 to 3.5 months (averaged 2.5 months). Complete radiological absorption of calcium sulfate was found in 1.2 to 3 months(averaged 2.2 months). Local exudation after removal of drainage tube had been persisting in 10 patients for 2 to 3 months, which was consistent with the time when cacium sulfate were totally absorbed. Flap had partial necrosis in 4 cases,and the wounds were closed after appropriate treatment finally. The mean Maryland score was 88.15±7.70. There were excellent results in 32 cases, good in 14, fair in 6.

CONCLUSION:

A satisfactory short-term clinical results can be gained by one-stage compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone in chronic calcaneal osteomyelitis, but the long-term results need further follow-up. And much more study is also demanded to reduce the exudation of calcium sulfate.

• Authors: Rui-jian Yan, Chun Zhang, Qiao-feng Guo, Jian-wei Lu
• Journal: Zhongguo gu shang = China journal of orthopaedics and traumatology (Zhongguo Gu Shang) Vol. 27 Issue 10 Pg. 854-7 (Oct 2014) ISSN: 1003-0034 [Print] China
• PMID: 25739254 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Calcium Sulfate

Topics

• Adolescent
• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Bone Transplantation
• Calcaneus (injuries, surgery)
• Calcium Sulfate (therapeutic use)
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Osteomyelitis (drug therapy, physiopathology, surgery)
• Surgical Flaps
• Wound Healing
• Young Adult