An aggressive course of pyoderma gangrenosum mimicking bacterial osteomyelitis after open reduction and internal fixation of a distal radius fracture with a titanium plate.

Pyoderma gangrenosum (PG) is a rare condition characterized by the development of aseptic, non-healing skin ulcers. Any skin trauma, such as a surgical incision, can trigger an outbreak of lesions. Our case and literature review show that a physician should consider PG in every event of a non-healing, aseptic wound after surgery.

Difficulties in identifying the bacterial species from the genus Clostridium in a case of injury-related osteitis.

Most Clostridium species are part of saprophytic microflora in humans and animals; however, some are well-known human pathogens. We presented the challenges in identifying the Clostridium species isolated from a patient with an infected open dislocation of the proximal interphalangeal joint of the fourth digit of the right hand. The clinical materials were intraoperative samples collected from a patient diagnosed with an injury-related infection, with soft tissue loss and tendon sheath involvement.

Orthopedic infections caused by obligatory anaerobic Gram-negative rods: report of two cases.

Anaerobic bone and joint infections are uncommon, although the number of anaerobic infections is presumably underestimated because of difficulties with isolation and identification of obligate anaerobes. This study describes two cases of complicated Bacteroides fragilis peri-implant infection of the lumbar spine, infection of the hip and osteomyelitis. Bacteria were identified with the use of a mass spectrometer, VITEK MS system.

Economic Analysis of 4221 Revisions Due to Periprosthetic Joint Infection in Poland.

Background: Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries.

Material And Methods: The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated.

Comparison of Bone Preserving and Radical Surgical Treatment in 32 Cases of Calcaneal Osteomyelitis.

Unlabelled: Radical procedures like calcanectomy and amputation performed for calcaneal osteomyelitis are regarded as effective in eradication of infection even though potentially functionally disabling. Bone sparing procedures offer better functional result at the expense of potentially worse infection control. The aim of the study has been to assess the influence of the surgical radicalism as much as the extent of bone infection on the final outcome in the surgical therapy of chronic calcaneal osteomyelitis (CO).

Wear of acrylic cement (methylene-polymethacrylate) can manifest as extraosseous cement granuloma or false aneurysm of the popliteal artery after total knee arthroplasty.

Wear particles of acrylic cement, similar to other biomaterials, can cause periprosthetic osteolysis and formation of extraosseous cement granuloma (ECG). Expansive granuloma can manifest as a tumorous mass adjacent to the knee prosthesis, or it even can damage the popliteal artery and lead to false aneurysm formation. Suspicion of these two conditions requires a complex diagnostic approach and eventually revision of the endoprosthesis itself or reparation of the popliteal artery.

Application of individually performed acrylic cement spacers containing 5% of antibiotic in two-stage revision of hip and knee prosthesis due to infection.

Deep infection of a joint endoprosthesis constitutes a threat to the stability of the implant and joint function. It requires a comprehensive and interdisciplinary approach, involving the joint revision and removal of the bacterial biofilm from all tissues, the endoprosthesis must be often removed and bone stock infection treated. The paper presents the author's experience with the use of acrylic cement spacers, custom-made during the surgery and containing low dose of an antibiotic supplemented with 5% of a selected, targeted antibiotic for the infection of hip and knee endoprostheses.

Open tibial fractures grade IIIC treated successfully with external fixation, negative-pressure wound therapy and recombinant human bone morphogenetic protein 7.

The aim of the therapy in open tibial fractures grade III was to cover the bone with soft tissue and achieve healed fracture without persistent infection. Open tibial fractures grade IIIC with massive soft tissue damage require combined orthopaedic, vascular and plastic-reconstructive procedures. Negative-pressure wound therapy (NPWT), used in two consecutive cases with open fracture grade IIIC of the tibia diaphysis, healed extensive soft tissue defect with exposure of the bone.

[Application of negative-pressure wound therapy in complex therapy of open tibia fractures IIIB and IIIC with massive soft tissue loss].

Patients with high-grade open tibia fractures and massive soft tissue damage pose a demanding clinical challenge, requiring a complex inter-disciplinary approach and multiple orthopedic, vascular and plastic-reconstructive procedures. These types of fractures still have a 50% risk of loss, although amputation remains a treatment method of last resort. In our experience negative-pressure wound therapy (NPWT), used in the form of the vacuum assisted closure - VAC System (KCI, USA) improves healing of excessive soft tissue damage with exposure of the bone accompanying open fracture of the tibia.

Characterization of transcription within sdr region of Staphylococcus aureus.

Staphylococcus aureus is an opportunistic pathogen responsible for various infections in humans and animals. It causes localized and systemic infections, such as abscesses, impetigo, cellulitis, sepsis, endocarditis, bone infections, and meningitis. S.

Application of clindamycin in therapy of orthopaedic infections with special regard to applicability in outpatients practice.

Background. There is presented the applicability of clindamycin alone or combined with chinolon group antibiotics in therapy of orthopaedic infections.
Material and methods.

[Septic loosing of hip and knee prosthesis].

Loosening of an artificial joint is a common complication in orthopedic surgery. It is estimated that bacteriological implant contamination is responsible for its loosening in 2-5 percent of cases, and in most cases aseptic loosening takes place. Despite low percentage of positive microbiological studies, histopathological examinations and modern laboratory techniques, including PCR (Polymerase Chain Reaction) allow to diagnose the bacterial contamination of the loose implant to ca 70 percent.

[Coronary angiography is not always helpful in differential diagnosis between perimyocarditis and myocardial infarction - four case reports].

Four males aged 17-42 years with ST-T segment changes suggesting perimyocarditis or non-Q acute myocardial infarction are presented. Coronary angiography was performed to establish the final diagnosis. Three patients had normal coronary arteries; two of them had typical clinical signs of perimyocarditis whereas the third patient had less typical changes.

[Evaluation of femoral neck fracture treatment with hemiarthroplasty in elderly patients].

The authors reviewed the medical records of 457 patients who underwent a hemiarthroplasty procedure for the treatment of displaced femoral neck fracture. The age of the patients ranged from 60 to 103 years (mean age: 83 years). Follow-up evaluation of 331 patients was done 4-114 months post-op (mean follow-up time 52 months).