Abstract
Introduction
Review the results of modified Lautenbach procedure (new method) to treat chronic osteomyelitis of the long bones.
Patients and methods
Retrospective analysis of sixty-seven patients with osteomyelitis of the long bones treated over 5-year period with modified Lautenbach procedure. Four patients were excluded from this study, as we were unable to retrieve the case notes. 48 men and 16 women were included and the average age was 33 years. All these patients had prior operative intervention including plating, intramedullary nailing or external fixator. Forty-seven patients had discharging sinuses and deformed leg. We noted the pre-operative inflammatory markers, bacteriology and pain score. We also recorded the duration of the hospital stay, post-operative recovery, deformity and the ability of the patient to resume his prior occupation.
Surgical technique
Surgical technique included radical debridement, reaming of the medullary canal and on table irrigation and lavage until all the debri was cleared. We did not use the continuous irrigation system originally used by Lautenbach. Arrangements were done for regular dressings of the wounds.
Results
Most of the patients got better with no signs of osteomyelitis. Four patients still has had sinuses. One patient needed amputation and another one arthrodesis. Eleven patients needed walking stick while others were able to mobilise without a walking aid. Twelve patients returned to their previous occupation, 39 changed their occupation and others were retired. The follow up radiographs revealed a solid union with no signs of osteomyelitis in 57 patients at the end of treatment.
Conclusion
The above-described method is easy and very effective. This is a modification of Lautenbach procedure and the results are impressive. This is more patient compliant as there is no need for the patient to stay in the ward for continuous irrigation.
