Abstract
The problem of chronic, haematogenous osteomyelitis is still a major one in developing countries. There are several patients who report with multiple discharging sinuses and a history of several operative procedures. The persistence of sepsis and repeated operations takes its physical, mental and financial toll.
The use of local muscle pedicle for filling saucerized cavities in chronic osteomyelitis was described by Starr and later by Ger. However, it has somehow not caught the fancy of Orthopaedic Surgeons.
The paper is a report of 55 cases of chronic osteomyelitis of long bones treated by use of the method. Anterior 1/3rd of Deltoid was used for proximal end of Humerus & lateral _ of brachialis for lower 1/3rd by a double breasting technique. The femoral shaft was filled by vastus lateralis by the author’s double breasting technique. The Medial Head of Gastrocnemius, soleus and Flexor Hallucis longus were used separately or in combinations for proximal 2/3rd of Tibia. The Abductor Hallucis was used for medial malleolus and calcaneum. A thorough debridement of necrotic and infected tissues preceded the application of muscle pedicle which was done as a single stage procedure.
The age of patients ranged from 8 yrs to 54 yrs with male preponderance. The followup of cases ranges between 18 months to 13 years with an average of 5.8 years.
All cases except 2 in femur showed no recurrence of sepsis. Two patients in femur had fracture through saucerized area.
It is concluded that filling of saucerized cavities with muscle graft obliterates the dead space as well as improves local vascularity. It adds only 20 minutes of operative time on an average and the technique is simple. It gives uniformly good results.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
