Yaputra Faldi, Hia Berkat, Telaumbanua Victor, Widyadharma I Putu Eka
Department of Pediatrics, Gunungsitoli General Hospital, Nias, North Sumatera, Indonesia.
Department of Neurology, Faculty of Medicine, Udayana University, Sanglah General Hospital, Bali, Indonesia.
Open Access Maced J Med Sci. 2019 Feb 25;7(4):610-613. doi: 10.3889/oamjms.2019.100. eCollection 2019 Feb 28.
Access to modern medicine is still limited in some rural areas in Indonesia. This is mostly due to lack of people's knowledge and concern for their health, especially in orthopaedic cases. Osteomyelitis is generally described as infection and inflammation of the bone, which results in local bone destruction, necrosis, and apposition of new bone. Chronic post-traumatic osteomyelitis (CPTO) is a complex condition and one of the most challenging problems in orthopaedic surgery that cause considerable morbidity.
We present a case of chronic post-traumatic osteomyelitis with radial nerve injury, in which radical surgical debridement and broad-spectrum antibiotic administration were done. A 12-year-old boy with a history of falling from the three-meter-high tree had swollen, deformed, and neglected humerus bone exposed. After stabilisation in the emergency room, surgical limb amputation was scheduled, yet the family refused this medical care and chose debridement instead.
This case is an important addition to the literature about chronic post-traumatic osteomyelitis with neglected bone exposed and the lacking of society's concern in regards to orthopaedic cases.
在印度尼西亚的一些农村地区，获得现代医学治疗的机会仍然有限。这主要是由于人们缺乏健康知识和对自身健康的关注，尤其是在骨科病例方面。骨髓炎通常被描述为骨的感染和炎症，会导致局部骨破坏、坏死以及新骨形成。慢性创伤后骨髓炎（CPTO）是一种复杂的病症，也是骨科手术中最具挑战性的问题之一，会导致相当高的发病率。
我们呈现了一例伴有桡神经损伤的慢性创伤后骨髓炎病例，该病例进行了根治性手术清创和广谱抗生素治疗。一名12岁男孩有从三米高树上跌落的病史，其肱骨肿胀、变形且外露，未得到及时治疗。在急诊室稳定病情后，原计划进行手术截肢，但家属拒绝了这种医疗方案，而是选择了清创。
该病例为有关慢性创伤后骨髓炎且伴有外露未治疗骨以及社会对骨科病例缺乏关注的文献增添了重要内容。
