A.definition Osteomyelitis simply means an infection of the bone or bone marrow. b.other name c.incidences d.risk fators e.

stages, types , classification Types of osteomyelitis There are two main types of osteomyelitis: Acute osteomyelitis is where the bone infection develops within two weeks of an initial infection, injury or underlying disease and may respond to antibiotic treatment. Chronic osteomyelitis is where the bone infection has produced irreversible bony changes that cannot be treated by antibiotics alone. classification the two most widely used in the medical literature in clinical practice are those presented by waldvogel et al , cierny et al. f.clinical manifestation g. pathophysio h. diagnostic exam a .ultrasound may detect a subperiosteal collection of fluid in early stages of osteomyelitis b .computarized tomography is particulary helpful in detecting smaller areas of cortical destruction c MRI has very high sensitivity and specifity for the dx of osteomyelitis d. radionuclide scans performed when the

I management Surgical General principles of surgical therapy include a. To remove dead, devitalized and infected bone b. To obliterate any dead space left after debridement Bone debridement the goal of debridement is to leave healthy, viable tissue

Waldvogel classification Accg. To the duration of the disease acute and chronic On the basis of the pathogenesis Hematogenous Usually occurs in Children long bones, usually lower extremety Cierny-mader staging system for osteomyelitis Anatomic type Stage 1: medullary osteomyelitis confined to medullary cavity ( hematogenous osteomyelitis) Stage 2: superficial osteomyelitis exposed infected bone at the base of the wound Stage 3: localized osteomyelitis full thickness cortical sequestration that can be removed without compromising stability Stage 4: diffuse osteomyelitis involvement of both the cortex and medullary cavity associated with loss of stability as in an infected non-union Cierny-Mader classification adds a second dimension to describe the host as either: A: patients without systemic or local compromising factors B: hosts affected by one or more compromising factors C: patients so severely compromised that treatment has an unacceptable risk-benefit ratio.