AI Article Synopsis

  • * Out of 27 patients studied, 40.7% showed residual osteomyelitis, with a higher rate in those who had partial metatarsal or transmetatarsal amputations compared to those who had toe amputations.
  • * Poor outcomes, including wound issues and re-amputation, were significantly linked to positive bone margins, suggesting the need for routine bone margin culture following amputation procedures.

Article Abstract

The purpose of this study was to determine the rate of residual osteomyelitis after different foot amputations in diabetic patients with a standardized method of determining a clean bone margin. This retrospective observational pilot study evaluated 27 diabetic patients who had a forefoot amputation (toe, partial ray, or transmetatarsal) for osteomyelitis at our institution from January 1, 2010, to August 1, 2011. A standardized method was used intraoperatively to determine if bone margins were negative for residual osteomyelitis. Short-term outcomes were assessed. Negative outcomes included wound dehiscence, re-ulceration, re-amputation, or death. The overall rate of residual osteomyelitis was 40.7% (11/27 patients). Patients who underwent toe amputation with joint disarticulation had a positive margin culture rate of 23.1% (3/13). Patients who underwent partial metatarsal or transmetatarsal amputation had a positive margin culture rate of 57.1% (8/14). Although twice as frequent, this was not considered to be statistically significant (p = .1201). Overall, 48.1% (13/27) of patients were considered to have poor outcomes, and 9/11 (81.8%) patients with a positive bone margin had poor outcomes, whereas only 4/16 (25%) patients with a negative bone margin had poor outcomes. This difference was considered statistically significant (p = .0063). Although this is a pilot study, our results do confirm the high incidence of residual osteomyelitis with associated poor outcomes. Based on our data, we recommend routine standardized bone margin culture after thorough debridement and irrigation.

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jfas.2012.06.017DOI Listing

Publication Analysis

Top Keywords

residual osteomyelitis
20
bone margin
16
poor outcomes
16
rate residual
12
diabetic patients
12
standardized method
12
margin culture
12
patients
9
patients standardized
8
bone margins
8

Similar Publications

Aims: The study is to investigate how residual osteomyelitis at conservative surgical resection margins affects the prognosis of diabetic toe osteomyelitis.

Methods: In this retrospective study, 67 participants with diabetic toe osteomyelitis who underwent conservative surgery were evaluated. The diagnosis of osteomyelitis was based on histopathology, and bone histopathology was done on the resection bone.

View Article and Find Full Text PDF
Article Synopsis
  • - The study tackles the significant issue of bone and joint infections by introducing a unique treatment method that combines local exosome and antibiotic delivery using a hydroxyapatite-based nanocement to fill spaces left after infection removal.
  • - Researchers created a special antioxidant herbal membrane that encourages the regeneration of periosteum, which is crucial for bone healing, and showed that their scaffolds are safe for the body and effectively fight bacteria.
  • - In experiments using a rat model of osteomyelitis, the treatment not only eradicated residual bacteria but also enhanced bone healing, showing a threefold increase in bone volume and complete formation of periosteal layers, indicating successful bone repair.
View Article and Find Full Text PDF
Article Synopsis
  • The study evaluates the effectiveness of 3D-printed porous Ti6Al4V prostheses for treating partial bone defects in lower limbs caused by osteomyelitis, aiming to improve clinical management of such challenging cases.
  • A comprehensive protocol was developed, including 3D simulations and finite element analysis (FEA) to assess stress conduction before and after prosthesis implantation, with a clinical study involving eight patients to monitor outcomes.
  • Results showed that the prostheses successfully reduced stress on residual bone, leading to significant functional improvements in most patients, with long-term stability and some instances of infection that required further intervention.
View Article and Find Full Text PDF
Article Synopsis
  • * Out of 530 patients analyzed, those with ROM showed a significantly higher risk of infection (2.0 times) and amputation (4.3 times) compared to those without ROM.
  • * Patients with ROM also required longer courses of antibiotics, with an average increase of 16.3 days compared to those without ROM.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare clinical outcomes between patients who underwent complete versus partial surgical resection for diabetic foot osteomyelitis (OM) using data from two clinical trials with 171 patients.
  • Patients with no residual osteomyelitis (NRO) experienced shorter durations of antibiotic therapy during hospitalization and follow-up compared to those with residual osteomyelitis (RO), but the NRO group had more amputations during the initial hospitalization.
  • Over a 12-month period, there were no significant differences in re-infection rates, ulcerations, or time to wound healing between NRO and RO patients, with successful treatment rates being similar for both groups.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: