Abstract
To evaluate the medium term results of the Lautenbach procedures for the treatment of chronic osteomyelitis [COM] in long bones.
Cohort of 17 patients (18 segments) prospectively treated. Mean age 37 years. High-energy trauma effecting 8 tibia (6 open) & 9 femora (5 open). Duration of COM was mean 12. 5 years (1–31 years). Discharging sinus present in all. Lautenbach procedure comprises intramedullary reaming/debridement to 13 mm and establishment of local antibiotic delivery system, cavity analysis for volume and culture. The end point is 3 clear culture results of the irrigate, improvement in blood indices and reduction of cavity volume.
Mean treatment time 27 days (14–48). Mean hospital stay 38 days. Two needed revision of Lautenbach procedure and one local debridement for recurrence of infection. 7 non-unions needed further fixation. 2 needed Papineau grafting and 3 had further limb lengthening procedures. Mean follow-up is 3. 3 years. 4 patients have been discharged, 1 awaiting THR.
This procedure permits precise control over the osteomyelitis cavity until objective assessment suggests that infection has been cleared and cavity obliterated.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom
