Traumatic osteomyelitis is a purulent inflammatory process that affects all parts of the bone tissue. It develops as a result of mechanical damage. Usually, the occurrence of pathology is explained by the penetration of Staphylococcus aureus into the wound. This occurs during injuries, surgery, and dressings. The disease can be both acute and chronic.
What damage contribute to the development of the disease?
Traumatic osteomyelitis is one of the most serious consequences of injuries.
However, not every effect leads to its occurrence. The disease develops as a result of damage to the bone tissue, which are open in nature. It is also observed after operations. Although surgical interventions rarely contribute to the onset of the disease. Traumatic osteomyelitis after such procedures develops in only three percent of cases. The likelihood of pathology is the same for individuals of any gender and age category.
Factors that increase the risk of illness
The circumstances that increase the chances of developing traumatic osteomyelitis include:
- The presence of severe bone injuries with damage to a large number of soft tissues.
- Poor or too late treatment and disinfection of the surface of the wounds.
- Weakened immune system.
- Alcohol abuse, drug addiction.
- The patient has sickle cell anemia.
- Depletion due to severe illnesses, radiation therapy, hemodialysis procedures.
How does the pathological process develop?
Traumatic osteomyelitis occurs due to exposure to microorganisms. The causative agents of the disease are most often: Pseudomonas aeruginosa, Proteus, anaerobic bacteria, streptococci and staphylococci.
Sometimes an infection develops as a result of the influence of several types of microbes. They can enter the body by contact or through the blood. The exact causes of the appearance of the pathology are not yet known. However, there are several hypotheses. They are described in the next section.
Theories explaining the causes of infection
Some scientists believe that the main factor in the onset of the disease is the characteristics of the vessels located in the bone tissue. These include a wide and loop-shaped network of capillaries, slow circulation of blood.
Other experts explain the cause of this ailment in a slightly different way. They believe that traumatic osteomyelitis occurs due to blockage of blood vessels in the bone tissue due to the activity of microbes. According to these scientists, it is pathogens that provoke necrosis and inflammation in the affected area.
There is another hypothesis. It lies in the fact that a latent infection is present in the patient’s body, which is exacerbated by external factors (prolonged exposure to cold, mechanical damage).
And finally, there is a theory called neuro-reflex. According to scientists who developed this hypothesis, the disease develops due to spasm of blood vessels and insufficient blood supply to tissues.
All of these statements are only probable explanations of the origin of the disease. However, it can be argued that the inflammatory process occurs against the background of the influence of many factors. Therefore, these theories seem to complement each other.
Types of ailment
There are several forms of traumatic osteomyelitis. Classification includes such varieties:
- Acute inflammation. It is divided into toxic, local (light) and heavy type.
- Chronic form of pathology. Sometimes it is a consequence of the acute course of the disease.
- Gunshot variety.
- Hematogenous type.
- Secondary form.
Signs of infection
Specialists pay much attention to the external manifestations of traumatic osteomyelitis. For diagnosis and treatment, they are extremely important. Symptoms of the disease are pronounced. The patient has a sharp rise in temperature, a feeling of weakness.
The affected area has a bright red shade, swells strongly, touching its surface provokes discomfort. There is an outflow of pus from the wound. If fluid is removed from the tissues, a fistula is formed at the site of damage, which does not heal well. Laboratory tests indicate an increase in the number of white blood cells. The patient also has signs of anemia.
Chronic type of pathology
This form is often the result of a decrease in the acute process of inflammation in the area of soft tissues.
A fistula forms on the surface of the skin or mucous membranes. Its appearance is accompanied by the expiration of pus. In chronic traumatic osteomyelitis, periodic deterioration of the patient's condition is possible. It is characterized by the formation of abscesses in the affected area.
Pathology detection
How to determine the presence of an ailment? With traumatic osteomyelitis, diagnosis is carried out primarily on the basis of external signs. This is due to the fact that on an x-ray, characteristic changes can be noticed only 30 days after the onset of the disease. In the course of this study, areas of narrowing of the canals of the spinal cord, foci of destruction of bone tissue and cavity are found. Another method by which pathology is detected is tomography. With traumatic osteomyelitis, differential diagnosis with various neoplasms is very important. For its implementation, laboratory tests and examination of the patient are carried out. In the bone tissue of a person with this pathology, pus is present, an increased number of leukocytes is found in the blood.
Swelling and discomfort in the affected area, a red tint of the skin also indicate the presence of an ailment.
Therapies
With traumatic osteomyelitis, treatment includes the following medical measures:
- The use of antibiotics ("Linkomycin", "Claforan"). The selection of medicines is carried out after determining the type of microbe that triggered the process of inflammation.
- Procedures aimed at removing toxins from body tissues and cells. Such measures include the introduction of special solutions (for example, "Hemodez"), blood purification using a laser, sorbents and ultraviolet radiation.
- Reception of the means improving body resistance ("Dekaris", "Timalina").
- The use of medicines that have anti-inflammatory and analgesic effects ("Analgin", "Aspirin").
If the myocardium is disturbed, specialists use drugs with a diuretic effect, glycosides.
Surgical intervention
In the acute type of pathology, surgery is performed in exceptional cases. The inflammation process is usually managed at the initial stage using other methods. However, if the positive effect of treatment cannot be achieved for several days, surgical intervention is necessary. It consists in the implementation of trepanation of the tissue of the affected bone and drainage to clean the affected area from fluid. After the operation, it is necessary to treat the wound with disinfectants.
If osteomyelitis occurs in a chronic form, special solutions must be placed inside the fistulas, as well as excision. Then the affected areas of bone tissue are removed. At the final stage of the surgical intervention, liquid removal (drainage) is also carried out. The wound should be periodically treated with disinfectants.
The affected parts of the body provide complete peace. The patient needs to use antibiotics. Further therapy consists of physiotherapy (treatment with electromagnetic fields, compresses). Patients are prescribed vitamin supplements, exercise therapy.
In order to prevent the development of pathology, it is necessary to timely and thoroughly disinfect the surface of the wound, to ensure peace for the affected area of the body. Clean dressings as needed.
In addition, you need to use the medications prescribed by the doctor to fight microbes.