Surgical treatment of chronic post-traumatic osteomyelitis of the femur in pseudarthrosis, ununited fractures and defects]

The authors have analyzed the results of treatment for chronic posttraumatic osteomyelitis of the femoral bone in 69 cases of ununited fractures, false joints ad femoral bone defects. The treatment included surgical sanation of the osteomyelitic nidus together with aspiration lavage drainage and extranidal osteosynthesis by external fixation as well as local and general antibacterial therapy. In 13 cases free bone autoplasty of the osteomyelitic cavities or defects was used together with spongious structures of iliac bone (crest and wing), in 2 of these patients it was applied for replacement of the large defects of the diaphysis of the femoral bone (8 and 12 cm). In 57 patients surgical treatment was carried out in one stage, a major requisite for this was the opportunity for joining bone fragments inside the open wound after sequestrectomy as well as stable external fixation by the apparatus. This treatment gave successful results in 97% of patients.