| Chronic osteomyelitis is mostly variated from acute osteomyelitis, and once happened, there may be a sinus tract and liquor puris will come from it. It can persistently unhealed for decades, even throughout life. Chronic abcesses can violate the skin by means of sinus tracks, which , when chronic, are associated with a risk of squamous cell carcinoma. It troubles many Orthopaedists and is miserable to patients. There are many approach to treat chronic osteomyelitis but no one can get a ideal therapeutic efficacy. It can cause severe functional deficiency and life-threaten. Chronic osteomyelitis is a great challenge to the orthopedic surgeons. Purpose To evaluate the clinical outcomes of osteomyelitis treated with vancomycin-calcium sulfat.Materials and method Group of vancomycin-calcium sulfate: Eighteen cases of chronic osteomyelitis were treated with vancomycin-calcium sulfate between 2004 and 2006. There were 14 males and 4 females with an average age of 41.3 years (range from 35 to 60 years).Of these cases, five were haematogenous osteomyelitis and for the rest were infected after internal fixation of fracture. The involved bones included femur in 4 cases, tibia in 13 cases and ulna in 1 case. The mean time of infection was 50.7 months (range from 6 months to 40 years). There were sinus tracts in all cases and liquor puris was effused from them. Secretion culture collected fromsinus tracts in 6 cases got Staphylococcus aureus. The granulation tissues got from debridement were sent for bacterial culture, antibiotic sensitivity examination and histopathology test. Vancomycin-calcium sulfate granules precipitated in the operation obturated the dead space after debridement. External fixator was used if the fracture was unstable.Group of control: 11 cases of osteomyelitis treated with gentamicin polymethylmethacrylate (PMMA) from 1999 to 2002 were retrospectively analysised. There were 8 males and 3 females with a mean age of 41.5 years (range from 30 to 52 years). The involved bones included femur in 2 cases and tibial in 9 cases. The average duration of infection was 27.9 months (range from 7 months to 10 years).There were sinus tracts in all cases and liquor puris was effused from them. Secretion culture collected from sinus tracts in 4 cases got Staphylococcus aureus. Gentamicin PMMA was use after thorough debridement.Results All of the 18 cases of vancomycin-calcium sulfate group were followed up. The mean time of follow-up was 16 months (range from 6 to 30 months). 1 case of tibial chronic osteomyelitis was failed because of repeat effusion from the wound. Seventeen of the 18 patients got control of the infection with an average 3.17 months (range from 2 to 5 months) course of treatment. All the tissue got from debridement was chronic inflammation in pathological report. The mean time of follow-up in control group was 21 months (range from 7 to 35 months).Six cases got control of the infection and 5 cases didn't. One patient got amputatioin. Statistic analysis: The difference between two groups in infection cure rate and the course of treatment was statisticly significant.Conclusino Treatment of chronic osteomyelitis with vancomycin-calcium is a relatively simple method. It has a high rate of infection control and short course of treatment.
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