Calcaneal Osteomyelitis: An Analysis of Aetiology and Pathogenic Organisms

Document Type

Article

Publication Date

1-1-1999

Identifier/URL

41076904 (Pure)

Abstract

Forty-nine cases of calcaneal osteomyelitis in 47 patients were evaluated between 1984 and 1993. Data on all osteomyelitis patients was collected prospectively in a computer data base. This data was reviewed to determine aetiology, pathogenic organisms and host characteristics of the patients. Aetiology was divided into five groups: diabetes mellitus (n=21); central nervous system lesion (n=10); post-traumatic (n=9); nail puncture wounds (n=5); and other (n=2). Each case was staged using the Cierny–Mader classification for osteomyelitis: IIA (n=3); IIB (n=16); IIIA (n=10); IIIB (n=18); IVB (n=2). Pathogenic organisms were categorized by each type of aetiology and host (A=uncompromised, B=compromised). Compromised hosts and patients with impaired sensation had more organisms cultured than uncompromised hosts. Treatment consisted of culture specific antibiotics (all); irrigation and debridement/partial calcanectomy (29); debridement with free flap (three); below knee amputation (10) and above knee amputation (one). All amputations were done in B hosts with impaired sensation. Eight of the 11 amputations were in diabetic patients. Patients with impaired sensation more commonly had multiple organisms cultured from their wounds and had a higher rate of amputation.

DOI

10.1046/j.1460-9584.1999.00158.x

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