Adult posttraumatic osteomyelitis of the tibial diaphysis of the tibial shaft

Osteomyelitis of the diaphysis of the tibia in adults is an uncommon but di sabling condition. It occurs principally in patients with complex fractures of the tibial shaft in which devitalized bone becomes infected either with a single strain of a virulent organism or with multiple organisms, The out come of treatment depends on the assessment and management of three interre lated factors, which are the vitality and stability of the bone, the virule nce and antibiotic susceptibility of the infecting organism, and the condit ion of the soft tissues, The impact of the infection on the patient's vital ity is of great importance, Successful management depends on control of inf lammation, excision of dead bone, and stabilization of the skeleton. Interl ocking nailing and local antibiotic treatment are particularly successful s trategies. In the future, modification of the inflammatory response with lo cal tissue mediators may become an important adjunctive therapy.