[Chronic infection following osteosynthesis].

The chronic infection following internal fixation may develop in a different pattern, according to the risk factor involved. There is no doubt that direct trauma on bone and soft tissue is an important risk factor. The pattern of each infection may differ according to the technique of internal fixation used, i.e. external fixator, plate or intramedullary nailing. The damages are minimized by using the appropriate technique. While bone necrosis in osteomyelitis is present, the pattern of it may be changing. An infected non-union may occur in osteomyelitis (osteitis) when present before bone-healing took place. Should infection overlast the bone-healing period, the localization of the main focus is determinant for the outcome of the infection. The assessment of an osteomyelitis consists in the evaluation of the patient's general aspect and the extension of the infectious disease. Assessing it by plain radiographs, it might be accompanied by leucocyte scanning, CT-scan or MRI. The indication of a more aggressive treatment of chronic osteomyelitis is given in all cases of infected nonunion, chronicle fistulation and in presence of pain and contractures. Antibiotics should only be used in addition to a surgical procedure.