Authors: Papagelopoulos, P.J.¹; Mavrogenis, A.F.¹; Tsiodras, S.²; Vlastou, C.³; Giamarellou, H.²; Soucacos, P.N.¹

Source: The Journal of International Medical Research, Volume 34, Number 6, November 2006 , pp. 704-712(9)

Publisher: Field House Publishing

Abstract:

The case of a 24-year-old woman with Pseudomonas aeruginosa and Proteus mirabilis chronic calcaneal osteomyelitis is presented. Extensive debridement of the necrotic bone and application of tobramycin-loaded polymethylmethacrylate beads was performed and ciprofloxacin was given post-operatively. Three months later, laboratory tests, including complete blood cell count, erythrocyte sedimentation rate and C-reactive protein, were normal. At this time, extensive surgical debridement and filling of the osseous defect with autologous iliac cancellous bone graft and tobramycin-impregnated calcium sulphate pellets and paste were performed. Oral ciprofloxacin was administered for 3 months after surgery. At the latest follow-up, 2 years later, the patient had full weight-bearing function; there was no recurrence of the infection, and complete incorporation of the autologous bone and calcium sulphate graft with the host bone was observed. This case demonstrates that two-stage surgical treatment with extensive debridement and tobramycinimpregnated calcium sulphate was effective in treating chronic calcaneal osteomyelitis.

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Keywords: TOBRAMYCIN; ANTIBIOTICS; CALCANEUS; OSTEOMYELITIS; POLYMETHYLMETHACRYLATE; (PMMA) BEADS; CALCIUM SULPHATE; DELIVERY SYSTEMS

Document Type: Research article

Affiliations: 1: First Department of Orthopaedics, Athens University Medical School, Attikon University Hospital, Athens, Greece 2: Fourth Department of Internal Medicine, Athens University Medical School, Attikon University Hospital, Athens, Greece 3: Department of Plastic and Reconstructive Surgery, Hygeia Athens Medical Centre, Athens, Greece

Publication date: 2006-11-01

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