Working in collaboration with local, national, and international facilities, the orthopedic medicine and surgery specialists at REOrthopaedics, Inc., in San Diego have spearheaded numerous scientific investigations that have led to practical treatment solutions bringing immediate benefits to patients and families throughout the world.
BONE FRACTURE/TRAUMA INFECTION
Bone fractures (cracks or breaks in a bone) need protection from re-injury and infection during the process of healing. In some cases, a non-union may arise if a bone fracture or other bone trauma does not heal correctly. If infection occurs, the result may be a deformity and/or complete failure for the bone ends to mend. Treatment for these types of bone infections is highly specialized and must be tailored to address the problems inherent to each, individual wound and patient.
Read below for information on the methods we offer to treat non-unions of bone and infections following bone fractures or other bone trauma at our Southern California practice, in close proximity to Mexico.
An infected acute fracture is an infection of a broken bone. The most common reason for infection (such as osteomyelitis) following a bone fracture is an "open fracture" where one or both ends of the bone break through their soft tissue coverings to be exposed to bacterial contamination. The break can come through the skin or penetrate deep, within the body, to puncture bowel or bladder. In these types of cases, early efforts are made to decontaminate the bone ends and safely stabilize the fracture to enable healing.
If the fracture is not "open" but requires an operation to stabilize the bone ends for healing, infection can occur at the surgical site, post-operatively. Although infection can occur after any operation, the most common reasons for infection following open orthopedic procedures are injury to the overlying soft tissues and/or compromise to the host in the form of a wound-healing deficiency. In either case, the wound does not seal to protect the bone ends from bacterial contamination. Infections such as osteomyelitis and wound healing deficiencies can occur in these cases, requiring treatment and staged reconstruction.
Although infection and the severity of the bone trauma are important deterrents to normal fracture healing, instability is the most common cause for a non-union. A non-union occurs when a bone does not heal within six to nine months after a break or fracture. There are several reasons why bone fractures or bone trauma may not heal, including:
There are risks of a non-union with any broken bone; however, certain areas like the ankle, shin and hip are more susceptible due to the poor blood flow to these bones. Treatment options for these bone fractures offered at our Southern California practice include surgery to not only freshen and stabilize the fracture, but also to improve the blood flow to the area to augment healing.
Our orthopedic specialists have extensive experience and knowledge in treating bone fractures and other types of bone trauma and can provide an individualized course of action.
Treatment methods for an infection following a bone fracture and other bone trauma are dependent on the type and extent of the injury as well as the health and specific needs of the patient;. However, in most cases, treatment will involve some form of stabilization to protect the injured tissues and promote healing.
In addition to treating all types of bone and soft tissue infections, we offer comprehensive treatment of bone fractures and bone trauma at our Southern California practice, not far from Mexico. The successful salvage and reconstruction of limbs afflicted with a non-union and/or infection (osteomyelitis) requires careful assessment of a broad spectrum of parameters pertaining to the disease, wound, host and the physicians caring for each patient and family. The factors listed below guide patient selection and the choice of materials and methods:
The methods used to restore a defect in bone caused by an infection have changed dramatically in the last twenty years. The change is primarily due to:
The figure below shows our selection of methods to restore 164 defects in the tibia bone over a recent, two year interval (2004 through 2005).
External fixation is gentle on tissues and is associated with a low risk for infection. The treatment involves stabilizing the bone through the use of a frame, situated outside the body (see figure below). The frame is attached by pins to the bone, above and below the injury . These pins transfer mechanical stresses to the frame, bypassing the injury and allowing the site to heal. The stability of the frame also allows the patient to function and weight bear during treatment. To avoid infection, the reconstruction takes place between the two sets of pins and, usually, without internal hardware.
Internal fixation is a staged protocol used whenever the reconstruction of the bone calls for fixation with a plate, rod, or joint prosthesis. Foreign matter and dead tissue will first be surgically removed from the wound (known as debridement). The wound will then be custom-stabilized with an antibiotic-infused acrylic spacer fortified by metal rebar (either pins or rods) to strengthen the construct and keep the patient mobile and weight-bearing throughout treatment (see figure below).
To further protect these implants, antibiotic beads are also inserted to establish the high antibiotic concentrations necessary to sterilize the wound.
After the wound heals and the patient recovers from surgery, which occurs within eight to 12 weeks, the second stage of the reconstruction takes place. It is at this time that the final form of fixation is utilized, including:
Methods for treating bone fractures and other bone trauma are based on the individual situation and injury. A comprehensive analysis will be performed by our orthopedic specialists to determine the appropriate course of treatment.
Infections following bone fractures or a bone trauma are a rare occurrence and require a specialist to determine an appropriate course of treatment.
At REOrthopaedics, Inc., our trained physicians have treated thousands of patients suffering from osteomyelitis and non-union following bone fractures or surgical trauma. Contact our Southern California practice for more information or to schedule a consultation. We are pleased to serve patients from nearby Mexico and across the globe.
7910 Frost Street, Suite 120
San Diego, California 92123
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Fax: (858) 300-0484