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INFECTION GUIDE

THE COMPLEX FRACTURE GUIDE 

Infection in bones can be caused by bacteria which can reach to the bone either by an open fracture or through the blood stream. Infection of the bone and it’s medullary cavity (which has bone marrow) is often termed as osteomyelitis. Infection can either be bacterial, fungal or other rare pathogens.

Types of Infections

The type of osteomyelitis depends on acuteness or the duration of symptoms. On the basis of time taken to affect the bone, osteomyelitis is divided into 3 sub categories:

  1. ACUTE OSTEOMYELITIS

Acute osteomyelitis develops within few days with severe pain, fever and swelling.

 

  1. SUB-ACUTE OSTEOMYELITIS

Sub-acute osteomyelitis develops within 1-2 months with pain and occasional fever.

 

  1. CHRONIC OSTEOMYELITIS

Chronic osteomyelitis develops mostly after 2 months and there may not be any fever and only mild pain.

 

Signs of Infections

The following signs may be present in the presence of bone infection:

  • Pain: patient has pain in the affected hand or leg
  • Swelling: as compared to the opposite side, the hand/ leg may be swollen
  • Redness: seen with acute osteomyelitis
  • Tenderness: pain on being touched or pressed on the affected part is called tenderness
  • Irritable: child is cranky, crying, refuses to eat and remains uneasy. 
  • Fever/ chills: temperature above 102° with shivering
Diagnosis

To confirm presence of bone infection following can be done:

  • Blood tests
  • Microbiological tests
  • X-ray
  • MRI scan
Risks of Infection

People having following conditions are considered at high risk of developing bone infections:

  • Weak immune system: can be result of diabetes, AIDS, chronic liver or kidney disease
  • Patient who has undergone recent bone or joint surgery
  • Open fracture: a fracture with break in the skin and external bleeding
  • Bone replace surgery
Treatment of Infections

Treatment depends on the type of osteomyelitis:

  1. Acute osteomyelitis

Treatment can be done by using appropriate antibiotics after getting blood/ fluid culture, to isolate the germs.

  1. Sub-acute and chronic osteomyelitis

Treatment depends on the severity of the bone affected/ damaged. If there is no damage to the bone then the treatment can be the same as that of acute osteomyelitis, whereas, if the bone is damaged treatment follows the same procedure as that of the chronic osteomyelitis. Chronic osteomyelitis treatment suggests the need for both antibiotics and surgery.

The surgery involves:

  • Removal of the pus
  • Removal of the diseased bone
  • Restoring blood supply to the left area
  • Stabilizing the affected bone
  1. Infection after bone/ joint surgery (Post operative infection)

The diagnosis requires test of the fluid/ pus discharge to find out which germs are causing the infection.

After diagnosis, the treatment requires surgery to clean up the operated wound thoroughly and to fill up the wound with antibiotic loaded cement beads.

If done properly and early, the cure rates are upto 95%.

 

  

 

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Dr. Pranav A. Shah is working currently as the Director of Orthopedic Trauma and Hip surgeries at CIMS hospital a JCI approved tertiary care well reputed corporate hospital in Ahmedabad. He was practicing earlier as a Senior Orthopedic Trauma Consultant Surgeon at Shalby Hospital, Ahmedabad from 2007 to 2017. Dr. Pranav Shah is a celebrated name as an eminent Orthopedic Surgeon who is highly recommended and referred to, because of his excellent skills and results even in most complex cases. 

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