BG Trauma Center, Ludwigshafen, Germany.
Arch Orthop Trauma Surg. 2013 Sep;133(9):1183-96. doi: 10.1007/s00402-013-1785-7. Epub 2013 Jun 16.
Osteomyelitis is a challenging diagnosis for every patient because of its protracted treatment process. Very experienced orthopaedic surgeons are needed to diagnose and treat this bacteria-related severe disorder in a right and proper way.
Different treatment options are possible for osteomyelitis at any stage: antibiotics in the acute and chronic stage for conservative treatment or radical debridement, bone fenestration, reaming, bone troughing, the Masquelet-technique, segmental resection with callus distraction, bone grafting and even amputation as surgical therapy.
Depending on different stages of the disease, there are good results with every technique available-on condition that radical debridement was performed. The complication rate is remarkable so that soft tissue defects should be assessed by using flaps to close the wounds in early stages.
The treatment of osteomyelitis should be done in centres with expertise in the treatment of this challenging disease. Different methods should be offered by surgeons and individual treatment concepts acquired together with the patient. The treatment of complications like soft tissue defects should be provided in the same centre and performed in short time lag to the prior surgery. The cooperation of the patient and surgeons of different specialities is mandatory in these cases.
骨髓炎是一种具有挑战性的疾病，每位患者的治疗过程都很漫长。需要非常有经验的骨科医生才能正确诊断和治疗这种与细菌有关的严重疾病。
在任何阶段，骨髓炎都有不同的治疗选择：急性和慢性阶段的抗生素用于保守治疗或彻底清创、骨开窗、扩髓、骨槽、Masquelet 技术、骨段切除和骨痂牵张、植骨，甚至作为手术治疗的截肢。
根据疾病的不同阶段，每种可用的技术都有良好的效果——只要进行了彻底的清创。并发症发生率显著，因此应尽早使用皮瓣评估软组织缺损，并及时关闭伤口。
骨髓炎的治疗应在治疗这种具有挑战性疾病方面具有专业知识的中心进行。外科医生应提供不同的方法，并与患者一起制定个体化的治疗方案。应在同一中心提供软组织缺损等并发症的治疗，并在与先前手术相近的时间内进行治疗。在这些情况下，患者和不同专业的外科医生的合作是强制性的。
