2-STAGE MANAGEMENT OF CHRONIC OSTEOMYELITIS OF THE LONG BONES - THE BELFAST TECHNIQUE

We treated 37 patients with chronic osteomyelitis of the tibia (25), f emur (9), radius (2) and humerus (1) by a two-stage technique, compris ing radical debridement of all infected bone and soft tissue with the provision of soft-tissue cover, and delayed autogenous bone grafting w hen necessary. All patients were reviewed at an average of 49 months ( 12 to 121). Infection-free bone union was achieved in 34. No patient r equired amputation. Wide excision of all compromised tissue and the cl osure of bone within a healthy vascularised soft-tissue envelope are e ssential if infection is to be eradicated. The combined assessment and management of such patients by an orthopaedic surgeon and a plastic s urgeon are advocated.