The exact definition of osteomyelitis is inflammation of bone or bone marrow or both, but for all practical purposes this inflammation invariably is the result of infection. Various factors responsible for osteomyelitis include vascular insufficiency due to any cause, hematogenous spread of infection from a distant focus and surgery or trauma. Acute Osteomyelitis usually presents with fever, chills, pain or irritability. The classic signs of inflammation, including swelling, or redness and limited joint movement may also occur. Chronic osteomyelitis may present with bone destruction and sequestrum formation and is a difficult form of osteomyelitis to treat.
Aims and Objectives: To study demographic details, organisms involved and outcome of treatment in patients with osteomyelitis.
Materials and Methods: After obtaining approval from institutional ethical committee we conducted a prospective study of 60 patients diagnosed with either acute, subacute or chronic osteomyelitis on the basis of imaging and culture and sensitivity. Patients were included in this study on the basis of predefined inclusion criteria and were treated by antibiotics and when necessary surgical intervention was done. In cases of skeletal tuberculosis appropriate antikochs treatment was given. Outcome of treatment was studied over a follow up period of 1 year. The data was tabulated and analyzed using SPSS 16.0 version software.
Results: Out of 60 cases of either acute, subacute or chronic osteomyelitis there were 38 males (63.33%) and 22 females (36.66%) with a M:F ratio of 1:0.57. Most common age group affected was found to be between 51-60 (36.66%) years. Acute, subacute and chronic osteomyelitis was seen in 71.66%, 11.66% and 16.66% patients respectively. Most common bones involved were Tibia (20%) and Femur (18.33%) followed by iliac bones (15%) fibula (11.66%) and vertebrae (11.66%). In most of the cases (36/60) contagious spread or trauma was the mechanism of infection. Comorbidities like hypertension, diabetes, chemotherapeutic agents or steroid intake and immunosuppression was present in 32 (53.33%) patients. S. Aureus (25/60) followed by Pseudomonas (7/60) and enterococci (7/60) were commonly isolated organisms. Atypical mycobacterial infection was seen in 1 patient who was immunocompromised. 40 patients were completely cured while remaining 10 patients had some or the other problem associated with chronic osteomyelitis. Amputations was done in 4 cases and septic arthritis developed in other 2 cases. 4 patients died during study period due to causes unrelated to osteomyelitis.
Conclusion: Diagnosis as well as management of osteomyelitis is a challenge for treating orthopaedician. Knowledge of predisposing factors, presenting complaints, possible complications and proper management is essential for successful management of acute as well as chronic osteomyelitis.