Abstract
A 17-year-old man presented with MRSA osteomyelitis of the femoral shaft after treatment for a closed fracture by an external fixator. Six weeks after radical debridement and resection at the infected site, the cement beads containing antibiotics were removed; and cultures of the intraoperative specimens were negative. The defect remained with a gap of 5.0 cm in length. A small callus was observed on the medial side of the defect on a radiograph of anteroposterior view. However, the size of the defect and callus remained un-changed over a 6 week period, so low-intensity pulsed ultrasound therapy was applied to the defect site. After two months of ultrasound exposure, rapid bone growth with radiographic bridging of the bone defect was observed, and the external fixator was removed. The fracture was completely consolidated three months after the initiation of the ultrasound treatment.
Résumé
Il s’agit d’un patient âgé de 17 ans présentant une ostéomyélite à staphylocoque doré méthicilline-résistant de la diaphyse fémorale après traitement par fixateur externe. Six semaines après mise à plat radicale et résection des tissus infectés, les billes de ciment aux antibiotiques furent enlevées et les cultures des prélèvements per-opératoires étaient négatives. Un défect osseux d’une longueur de 5 cm persistait. Un faible cal était visible à la partie médiale interne du défect sur une radiographie de face. Cependant, la taille du défect et du cal osseux restait inchangée après une évolution de six semaines et l’on décida d’appliquer une ultra-sonothérapie à basse intensité. Après deux mois d’application de cette physiothérapie ultra-sonique une croissance osseuse rapide avec pontage du défect radiologiquement visible fut observée et le fixateur externe put être enlevé. La fracture était entièrement consolidée trois mois après le début du traitement aux ultra-sons.
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Fujishiro, T., Matsui, N., Yoshiya, S. et al. Treatment of a bone defect in the femoral shaft after osteomyelitis using low-intensity pulsed ultrasound. Eur J Orthop Surg Traumatol 15, 244–246 (2005). https://doi.org/10.1007/s00590-005-0235-9
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DOI: https://doi.org/10.1007/s00590-005-0235-9