Saturday, March 18, 2000
The researchers found limb salvage appears to be a satisfactory option for patients with chronic tibial osteomyelitis. They said that the likelihood of returning to a functional level including ability to work and participate in previous recreational activities is very promising in the motivated patient.
Forty-six patients with at least 24 months follow-up, who had undergone limb salvage for chronic, refractory tibial osteomyelitis were evaluated by interview, examination and chart review. A modification of the Limb Extremity Outcomes Instrument was utilized emphasizing inquiries pertaining to quality of life.
A successful outcome is defined as pain-free independent ambulation, including the ability to perform activities of daily living. Pre-existing factors which may help to predict successful or poor outcome were evaluated and included: smoking history, age, Cierny-Mader classification, type of flap utilized and presence of intraarticular involvement.
Thirty-nine of the 46 (85 percent) patients had pain-free independent ambulation. A successful outcome was found in 70 percent of those patients more than 45 years old and in 100 percent of those less than 45 years of age. Of patients with a positive smoking history, 31 percent were failures and 71 percent of all poor outcomes were smokers. Seventy-one percent of failures were Cierny-Mader physiologic type B and anatomic type IV. Sixty-eight percent of patients were able to resume their prior occupation. Two patients with ipsilateral intraarticular involvement were associated with a poor outcome. All patients were infection free at last follow-up.
Co-authors of the study, all of the Keck School of Medicine, University of Southern California, are Michael J. Patzakis, MD, professor and chairman, department of orthopaedic surgery; Paul D. Holtom, MD, associate professor of clinical medicine and orthopaedics, division of infectious diseases, department of medicine; Randy Sherman, MD, professor and chairman, division of plastic surgery, department of surgery; Lane Shepherd, MD, assistant professor of orthopaedics, department of orthopaedic surgery; and Herrick J. Siegel, MD, resident, USC orthopaedic residency program.
Herrick J. Siegel, MD; Michael J. Patzakis, MD; Paul D. Holtom, MD; Randy Sherman, MD; and Lane Shepherd, MD.
|2000 Academy News March 18 Index C|
Last modified 24/February/2000 by IS