INTRAMEDULLARY REAMING AND SOFT-TISSUE PROCEDURES IN TREATMENT OF CHRONIC OSTEOMYELITIS OF LONG BONES

Forty patients suffering from chronic osteomyelitis were treated by in tramedullary reaming at the authors' clinic from 1985 to 1991. The pat ients were divided into two groups according to follow-up time. The ob servation period averaged 4.4 years in the intermediate-term group and 1.7 years in the short-term group. Four patients suffered a recurrenc e. Special attention was given to plastic surgical procedures involvin g intramedullary reaming. Techniques and results of 7 fasciocutaneous flaps, 1 pedicled gastrocnemius muscle flap, and 1 free microvascular rectus abdominis muscle flap are reported. Intramedullary reaming is r ecommended as a valuable method in the treatment of long-term chronic osteomyelitis. Primary soft tissue grafting with the objective of prov iding total wound coverage with all available means seems to be the mo st advantageous method of achieving primary wound healing and avoiding reinfection.