Deformity correction in osteomyelitis

Skeletal deformities do occur after conservative or operative fracture trea tment, as a consequence of congenital growth disturbance and as sequlae aft er posttraumatic and haematogenous osteomyelitis. In postinfectious deformi ties the course of the bone and soft tissue infection plays a decisive role when choosing the appropriate operative technique. Even in non active situ ations with a closed soft tissues envelope and no draining sinus persistenc e of germs within the bone has to be anticipated. The biological quality of the bone and the soft tissue envelope is often reduced because of local ch anges and as a result of multiple local revisions. Consequently wide areas of scar tissue and sclerotic bone are often encountered. The apex of the de formity is in most cases identical with the focus of the active or non acti ve infection. The correction of the deformity at the apex can therefore onl y be accomplished if the infectious bone is also resected. If a correction is not possible at the apex of the deformity, translation at the osteotomy site is necessary to achieve a correct mechanical axis. The later rather co mplex operative procedure necessitates intensive preoperative planning and an extensive experience with deformity corrections by external fixators.