Abstract
Introduction: One of the more difficult questions in the management of posttraumatic osteomyelitis is the decision for removing or retaining infected hardware. We know that skeletal stabilization in posttraumatic osteomyelitis is necessary for controlling infection. However, in the presence of internal fixation, microorganisms are protected in a biofilm adherent to the implant surface. The decision to retain or remove infected implants is individualizated and depends on several factors: status of bone healing, stability provided by the hardware, fracture localization, and time since fracture fixation.
Material and Method: We used in our Hospital the algorithm proposed by Patzakis and Zalavras1 in 2005. The objective of our lecture is to define the decision to remove the implant with some case reports.
Conclusion: The management of infected hardware in patients with postraumatic osteomielitis in long bones is difficult and it is necessary to study each cases individualizated but it is necessary to have a guidelines.
We must remove the implant:
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If the fracture has healed.
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If the fracture has not healed and the implant does not provides stability.
Bibliography:
Correspondence should be addressed to Vienna Medical Academy, Alser Strasse 4, A-1090 Vienna, Austria. Phone: +43 1 4051383 0, Fax: +43 1 4078274, Email: ebjis2009@medacad.org
References
Patazakis M.J., Zalavras Ch G. Chronic Postraumatic Osteomyelitis and infected non-union of the tibia: Current Management concepts. J Am Acad Orthop Surg2005;13:417–427. Google Scholar
