Minimally Invasive Decompression Reamed Bored External Fixator In The Repair Of Chronic Sclerosing Osteomyelitis Of The Femur: Follow-up Of 15 Cases Of Bone Healing

Objective: To explore the bone healing under dual role of strong fixation and effective pressure in 15 cases of chronic sclerosing osteomyelitis using minimally invasive decompression reamed bored external fixator. Methods: Clinical data of patients with chronic sclerosing osteomyelitis of the femur were retrospectively analyzed. A total of 15 cases of chronic sclerosing osteomyelitis of the femur, who were treated in the First Affiliated Hospital, Xinjiang Medical University from February 2010 to October 2013, were enrolled in this study. According to radiographs, we found the extent and location of lesions, and designed an external fixator. Medullary cavity was penetrated towards distal and proximal ends. Simultaneously, closed bone surface was drilled with an electric drill. At anterolateral femur, two rows of holes were made on the long axis, with a row spacing of about 1.0 cm and hole spacing of 0.5 cm. The depth was about equal to the center of medullary cavity. The length was equal to the length of the affected region. Reamed incision was locally immersed with sensitive antibiotics, and marrow cavity received closed drainage for 5 minutes. Knee flexion was at 90°. Both ends of anterolateral femoral lesion were parallelly fixed with single-arm external fixator. Results: All patients were followed up for 10-28 months, averagely 15 months. There were 10 healed cases, effective effects in 4 cases and invalid effects in 1 case. After fixation, the affected limb affected pain in the patients with effective effects. Suppuration at the mouth of sinus tract was significantly improved. At 6 weeks after removal of the fixator, pain appeared surrounding the original incision, and disappeared after 2 weeks of intravenous infusion of antibacterials. Knee flexion was lightly limited in invalid patients. Conclusion: Compared with pre-fixation, Visual Analog Scale pain score, erythrocyte sedimentation rate, serum C-reactive protein levels were significantly lower after fixation in patients with chronic sclerosing osteomyelitis of the femur(P < 0.05). Above results indicated that minimally invasive decompression reamed bored external fixator in the repair of chronic sclerosing osteomyelitis of the femur is effective for bone healing.