Volume 19 Issue 10
Oct.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(10): 1654-1657,1684
ZHU Yan, ZHU Jie, ZHOU Guang-xin, QIAN Hong-bo, HE Zhi-wei. One-stage surgical treatment for Cierny-Mader type Ⅱ and Ⅲ chronic calcaneus osteomyelitis: Single-centre experience of 63 cases[J]. Chinese Journal of General Practice, 2021, 19(10): 1654-1657,1684. doi: 10.16766/j.cnki.issn.1674-4152.002134
Citation: ZHU Yan, ZHU Jie, ZHOU Guang-xin, QIAN Hong-bo, HE Zhi-wei. One-stage surgical treatment for Cierny-Mader type Ⅱ and Ⅲ chronic calcaneus osteomyelitis: Single-centre experience of 63 cases[J]. Chinese Journal of General Practice, 2021, 19(10): 1654-1657,1684. doi: 10.16766/j.cnki.issn.1674-4152.002134
shu

One-stage surgical treatment for Cierny-Mader type Ⅱ and Ⅲ chronic calcaneus osteomyelitis: Single-centre experience of 63 cases

doi: 10.16766/j.cnki.issn.1674-4152.002134

  • Department of Orthopaedics, Eastern Theater General Hospital of PLA, Nanjing, Jiangsu 210002, China

Funds:

 M2020025

  • Received Date: 2020-06-07
    Available Online: 2022-02-15
    Abstract
  •   Objective  Chronic calcaneal osteomyelitis has many pathogenic factors and complex classification, and it is challenging to treat. This study retrospectively analysed the clinical characteristics of Cierny-Mader type Ⅱ and Ⅲ chronic calcaneal osteomyelitis and explored the clinical efficacy of one-stage surgery and related factors of limb function.  Methods  A retrospective case series study was conducted to analyse the clinical data of 63 patients with Cierny-Mader type Ⅱ and Ⅲ chronic calcaneus osteomyelitis admitted at the Eastern Theater General Hospital from January 2005 to December 2018. A total of 55 patients were males, and 8 were females. The ages ranged from 6 to 68 years, with the median age of 39 (23, 57) years. According to the Cierny-Mader classification, 32 cases had type Ⅱ disease, and 31 had type Ⅲ disease. Thirty-two patients with type Ⅱ disease were treated with debridement, and 18 patients with type Ⅲ disease were treated with autologous bone implantation after debridement. The remaining 13 patients with type Ⅲ disease were treated with antibiotic bone cement after debridement. The American Orthopaedic Foot and Ankle Society's hind foot (AOFAS-AH) score was used to assess the postoperative limb function.  Results  All patients were followed up for 12-68 months. A total of 8 cases recurred, of which 5 with type Ⅱ disease recurred. Two of the 18 patients with type Ⅲ disease recurred, and 1 case in 13 patients with type Ⅲ disease who were treated with antibiotic bone cement after debridement recurred. The AOFAS-AH score improved from preoperative (63.4±7.6) points to postoperative (84.8±7.4) points. After statistical analysis, the preoperative limb function was found to be related to the Cierny-Mader classification (P < 0.001) and the aetiology of calcaneal osteomyelitis (P=0.005), and the postoperative AOFAS score was related to the patient's age (P=0.018) and aetiology (P=0.035).  Conclusion  One-stage surgery is an effective method for Cierny-Mader type Ⅱ and Ⅲ chronic calcaneus osteomyelitis with short treatment cycle and good curative effect.

     

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