Osteomyelitis of the First Metatarsal Head Treated With Joint-Preserving Surgery and a Synthetic Resorbable Bone Graft Substitute: A Case Report.

Abstract

Managing infections of the first metatarsophalangeal joint can be demanding because many patients present with late-stage infection and partial or total amputation of the first ray or the phalanx could be necessary. We describe such a patient who was successfully treated with a calcium-based resorbable bone substitute that preserved the first metatarsophalangeal joint. A 38-year-old female presented to our department with a foot infection. Examination revealed a methicillin-susceptible Staphylococcus aureus infection of the first metatarsophalangeal joint. The histopathologic findings confirmed active osteomyelitis of the first metatarsal head. The metatarsophalangeal joint was debrided with open synovectomy, the metatarsal head was curetted, and the bone defect was filled with 2 mL of a synthetic bone graft substitute. Two years later, she reported no problems with function or pain, the joint had full range of motion, and she had no local or systemic signs of infection. The most recent radiographs revealed no damage to the first metatarsophalangeal joint. A synthetic bone graft substitute can be a good alternative for treating forefoot infections when the soft tissues are intact and the bone defect is not so large that partial or full amputation is necessary.

• Authors: Konstantinos Anagnostakos, Katrin Koch
• Journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons (J Foot Ankle Surg) 2018 Sep - Oct Vol. 57 Issue 5 Pg. 1010-1013 ISSN: 1542-2224 [Electronic] United States
• PMID: 29655648 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Bone Substitutes

Topics

• Adult
• Bone Substitutes (therapeutic use)
• Female
• Humans
• Metatarsal Bones
• Metatarsophalangeal Joint
• Osteomyelitis (diagnosis, surgery)
• Staphylococcal Infections (diagnosis, surgery)
• Staphylococcus aureus