The Ohio State University Medical Center, Columbus, Ohio.
Semin Plast Surg. 2009 May;23(2):59-72. doi: 10.1055/s-0029-1214158.
Long bone osteomyelitis presents a variety of challenges to the physician. The severity of the disease is staged depending upon the infection's particular features, including its etiology, pathogenesis, extent of bone involvement, duration, and host factors particular to the individual patient (infant, child, adult, or immunocompromised). Long bone osteomyelitis may be either hematogenous or caused by a contiguous spread of infection. A single pathogenic organism is almost always recovered from the bone in hematogenous osteomyelitis; Staphylococcus aureus is the most common organism isolated. A variety of multidrug-resistant organisms of bacteria continue to be a source of concern in arresting infection. The primary weapons to treat these infections are culture-specific antibiotics, aggressive debridement, muscle flaps, and bone grafts. This article offers a basic review of the classification, etiology, epidemiology, pathogenesis, and treatment of long bone osteomyelitis.
长骨骨髓炎给医生带来了各种挑战。疾病的严重程度根据感染的特定特征进行分期，包括其病因、发病机制、骨受累的范围、持续时间以及个体患者的特定宿主因素（婴儿、儿童、成人或免疫功能低下者）。长骨骨髓炎可以是血源性的，也可以是由感染的直接蔓延引起的。在血源性骨髓炎中，几乎总是可以从骨骼中分离出单一的病原体；金黄色葡萄球菌是最常见的分离菌。多种耐多药细菌不断成为控制感染的关注点。治疗这些感染的主要武器是针对特定病原体的抗生素、积极清创、肌瓣和骨移植。本文对长骨骨髓炎的分类、病因、流行病学、发病机制和治疗进行了基本回顾。
