On-line version ISSN 2078-5151
S. Afr. j. surg. vol.46 n.4 Cape Town Nov. 2008
Samuel B. AgajaI; Raphael O. AyorindeII
IF.R.C.S., F.W.A.C.S; Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
IIM.B.B.S., F.W.A.C.S. (ORTH.); Department of Orthopaedic and Trauma Surgery, Kwara State Specialist Hospital, Sobi, Ilorin, Nigeria
AIM: To review cases of chronic osteomyelitis managed at a private health institution (Ela Memorial Medical Centre, Ilorin, Nigeria) between March 1995 and February 2005.
PATIENTS AND METHODS: Case notes and X-rays of the patients who presented at EMMC with chronic osteomyelitis were reviewed retrospectively. Age, sex, sites of bone involvement and outcome of treatment were recorded. Local surgical debridement (including saucerisation, sequestrectomy and curettage) was the cornerstone of treatment. All patients received antibiotics for at least 6 weeks.
RESULTS: Of the 107 cases, 71 (66.4%) were males, with a male-to-female ratio of 2:1. The mean age was 21.9 years (range 1.5 - 80 years). Chronic osteomyelitis is most common in the first and second decades of life (55.2%) and mostly affects people <50 years of age (93.5%). Haematogenous osteomyelitis was the most common cause of chronic osteomyelitis (81.3%). The most common bone site was the tibia (32.7%). Nearly all (103) were adjudged cured; only 3 patients suffered a recurrence.
CONCLUSION: Chronic osteomyelitis is common in Nigeria. Most cases occur in the first and second decades of life, with haematogenous osteomyelitis being the most common cause. A high index of suspicion of osteomyelitis in children with septicaemia, and the proper treatment of patients with open fractures, will help to reduce the occurrence of the disease.
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1. Wanner WC, jr. Osteomyelitis. In: Jones L, Canale T, Canale ST, eds. Campbell's Operative Orthopaedics 9th ed. St Louis, MO: Mosby, 1998. [ Links ]
2. Nade S. Acute and chronic osteomyelitis. Surgery 1997; 15(1): 248-252. [ Links ]
3. Onuminya JE, Onabowale BO. Outcome of chronic osteomyelitis in Nigeria. Journal of Applied and Basic Sciences 2003; Vol.1 no. 1 & 2: 27-32. [ Links ]
4. McNally AM, Small OJ, Tofighi GH, Mollan BAR. Two-stage management of chronic osteomyelitis of long bones: The Belfast technique. J Bone Joint Surg 1993; 75B (3): 375-380. [ Links ]
5. Wordsworth P. Diseases of bones and joints: Infections. In: Russell RCG, Williams NS, Bulstrode CJK, eds. Bailey and Love's Short Practice of Surgery. 24th ed. London: Arnold, 2004: 419-430. [ Links ]
6. Katchy UA, Agu CT, Nwankwo EO. Chronic osteomyelitis in 110 patients. Niger Postgrad Med J 2000; 7(2): 49-53. [ Links ]
7. McAllister TA. Treatment of osteomyelitis. Br J Hosp Med 1994; 12: 535-545. [ Links ]
8. Anthony JP, Mathes SJ. Update on chronic osteomyelitis. Clinic Plastic Surg 1991; 18(3): 515-523. [ Links ]
9. Cierny G, Mader JT, Penninch JJ. A clinical staging system of adult osteomyelitis. Contemp Orthop 1985; 10: 17. [ Links ]
10. Essien JAI, Ndukwe UA. Chronic osteomyelitis. A 12-month experience at the National Orthopaedic Hospital, Enugu. Niger Postgrad Med J 1994; 1(3): 22-25. [ Links ]
11. Ofiaeli RO. Radiological features of chronic osteomyelitis in long bones and the effects on diaphysical sequestration on linear growth. Orient J Med 1991; 3(2): 20-22. [ Links ]
12. Infections. In: Solomon L, Warwick D, Nayagam S, eds. Apley's System of Orthopaedics and Fractures. 8th ed. London: Arnold, 2001: 27-48. [ Links ]
13. Green AS. Osteomyelitis: The Ilizarov Perspective. Orthop Clin North Am 1991; 22(3): 515-521. [ Links ]
14. Agaja SB. Road traffic injuries: A serious cause for concern in Nigeria. Niger Clin Rev 2005; 9(3): 33-42. [ Links ]