Clinical Observation of the Acute and Chronic Osteomyelitis of the Tibia

Hahn Moon-Sik; Chang Jin-Kwan

doi:10.4055/jkoa.1975.10.1.276

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Moon-Sik and Jin-Kwan: Clinical Observation of the Acute and Chronic Osteomyelitis of the Tibia

Original Article

J Korean Orthop Assoc 1975;10(3):276-281.

Published online: 19 September 1975

DOI: https://doi.org/10.4055/jkoa.1975.10.1.276

Clinical Observation of the Acute and Chronic Osteomyelitis of the Tibia

Hahn Moon-Sik, M.D., Chang Jin-Kwan, M.D.

¹Department of Orthopedhc Surgery, College of Medicine, Seoul National University Hospital

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Clinical observation of the acute and chronic osteomyelitis of the tibia has been made on 124 patients, who had been treated at the Department of Orthopedic Surgery, College of Medicine, Seoul National University Hospital from January, 1964 to August, 1974.

The pyogenic osteomyelitis occured in male three times more frequently than female. The peak incidence was found among the age group of 10 to 19 year-old patients, and the proximal one-third was the more prevalent site as well known. The isolating organism was staphylococcus in 78.3%.

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Table 1.

Incidence by year

Year	Acute	Chronic	Total
1964	1	8	9
1965	0	10	10
1966	4	7	11
1967	2	7	9
1968	1	11	12
1969	5	3	8
1970	3	5	8
1971	3	10	13
1972	4	10	14
1973	4	14	18
1974.8.	2	10	12
Total	29	95	124

Table 2.

Age and Sex Incidence

Age (year)	Acute		Chronic		Total
Age (year)	Male	Female	Male	Female	Total
0-9	10	4	10	6	30
10-19	10	3	28	12	53
20-29		1	12	2	15
30-39		1	13	2	16
40-49			2	0	2
50 㢌㼿			7	1	8
Total	20	9	72	23	124

Table 3.

Duration of Disease

Duration	No. of Cases
Less than lwk	5
Iwk—2wk	9
2wk—4wk	15
IM—3M	24
3M-6M	27
6M—1Y	12
More than 1Y.	32

Table 4.

Duration of Hospitalization

Duration	No. of Cases
Less than lwk	3
lwk—2wk	25
2wk—4wk	62
1M—2M	22
2M-3M	5
3M—6M	4
More than 6M	3
Total	124

Table 5.

Location of Lesion

Location	No. of Cases	Pescent
Proximal 1/3	72	58.0
Middle 1/3	18	14.5
Distal 1/3	34	27.5
Total	124	100.0%

Table 6a.

Result of Bacterial Examination

Bacteria	No. of Cases
Staphylococcus	76
Streptococcus	O
Proteus	3
Pseudomonas	4
E. Coli	6
Aerobacter aerogenes	2
Alkaligenes fecalis	3
Total	97

Table 6b.

Sensitivity test of Staphylococcus

Drug	Very snscept.	Moderate suscept.	Slight snscept.	Resistant
Penicilline	3	5	2	66
Stroptomycin	18	6	9	43
Kanamycin	36	14	11	15
Leucomycin	32	16	10	18
Albamycin	16	16	10	31
Chloromycin	20	35	9	11
Cloxacillin	14	26	7	5
Neomycin	31	12	5	3
Terramycin	18	10	7	40
Erythromycin	10	4	6	25
Lincocin	8	2	8	5

Table 7.

Method of Treatment

Treatment	No. of Cases	No. of cure
Conservative	7	7
Curettage and primary closure	20	18
Fenestration and vaseline gauze packing	15	11
Multiple drilling and vaseline gauze packing	12	8
Saucerization and vaseline gauze packing	30	22
Saucerization and tube irrigation	33	28
Amputation	4	4
Soleus M. transference	1	1
Tibiofibula cross-peg grafting	2	2

Table 8.

Method of Approach to the lesion

Approach	No. of cases
Approach	prox. 1/3	mid. 1/3	dist. 1/3
Medial (Phemister)	26	7	5
Anterior	25	4	5
Anterolateral	10	3	3
Posterior	12		8
Posterolateral (Harmon)		4	13
Total	72	18	34

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