The treatment of tibial defects following chronic pyogenic haematogenous osteomyelitis in children

摘要

The aim of this paper was to review the results of treatment of 31 children, aged 3 to 12 years, with tibial defects resulting from haematogenous osteomyelitis seen between 1989 and 2006. Common features were skin defects, discharging sinuses, pathological fractures, sequestra and pseudarthroses, with a duration of 4 to 12 months prior to reconstruction. The defects ranged from 2 to 20 cm, 18 were in the proximal third of the tibia, 10 in the middle third, and three in the distal third. Surgical treatment consisted of repeated debridement, sequestrectomy, gentamycin beads and soft tissue cover for skin defects, followed by reconstruction at a later stage. Bone grafting was done by using cancellous chips in cavitating defects (Papineau technique) (n = 2), onlay grafting in defects