Department of Orthopaedics, Hospital Tengku Ampuan Najihah, Kuala Pilah, Negeri Sembilan, Malaysia.
Department of Orthopaedics, Traumatology and Rehabilitation, Faculty of Medicine, International Islamic University of Malaysia, Kuantan, Pahang, Malaysia.
Singapore Med J. 2022 May;63(5):251-255. doi: 10.11622/smedj.2020164. Epub 2020 Dec 2.
The clinical outcomes and factors associated with treatment failure of post-traumatic osteomyelitis have been investigated in many studies. However, limb functionality and quality of life following treatment for this condition have not been thoroughly studied.
This cross-sectional study included 47 patients with post-traumatic osteomyelitis of the lower limb. Functional outcome was assessed using the Lower Extremity Functional Score (LEFS), and quality of life was assessed using the validated Malay version of the Short Form-36 questionnaire version 2.
The mean follow-up period was 4.6 (range 2.3-9.5) years, and the median age of the patients was 44 years. Osteomyelitis was located in the tibia for 26 patients and in the femur for 21 patients. Osteomyelitis was consequent to internal infection in 38 patients and due to infected open fractures in nine patients. 42 (89.4%) patients had fracture union and control of infection. Bone defect was found to be a significant contributing factor for treatment failure (p = 0.008). The median LEFS for the success group was 65, compared to 49 for the failure group. Although the success group showed better scores with regard to quality of life, the difference between the two groups was not statistically significant.
Treatment of post-traumatic osteomyelitis of the lower limb had a high success rate. The presence of a bone defect was associated with treatment failure. Successfully treated patients had significantly better functional outcomes than in those in whom treatment failed.
许多研究已经调查了创伤后骨髓炎的临床结果和与治疗失败相关的因素。然而，这种疾病治疗后的肢体功能和生活质量尚未得到充分研究。
本横断面研究纳入了 47 例下肢创伤后骨髓炎患者。使用下肢功能评分（LEFS）评估功能结局，使用经过验证的马来语简短形式 36 问卷版本 2 评估生活质量。
平均随访时间为 4.6 年（范围 2.3-9.5 年），患者的中位年龄为 44 岁。骨髓炎位于胫骨 26 例，股骨 21 例。骨髓炎继发于 38 例内感染，9 例因感染性开放性骨折引起。42 例（89.4%）患者骨折愈合和感染得到控制。骨缺损被认为是治疗失败的一个重要因素（p=0.008）。成功组的中位 LEFS 为 65，而失败组为 49。尽管成功组在生活质量方面表现出更好的评分，但两组之间的差异无统计学意义。
下肢创伤后骨髓炎的治疗成功率较高。存在骨缺损与治疗失败相关。成功治疗的患者的功能结局明显优于治疗失败的患者。
