[Recurrent post-traumatic osteitis of the leg: Patent Blue V® dye, Gentamicin-PMMA-Beads and double muscular flap].

Abstract

The authors describe the case of a 31-year old man who had a recurrent post-traumatic osteitis of the left leg with two fistulae for more than one year. Many unsuccessful proceedures were tried: removal of the tibial nail with reaming and filling with Gentamicin-PMMA-beads, fascio-cutaneous flap and open cancellous bone graft. They emphasize the bacteriological and imaging examinations particularly MRI. They recommend high-pressure oxygen therapy for a few days before operation in the case of chronic infected tissues, the use of Patent Blue V® dye to display bone sequestra prominently, filling with Gentamicin-PMMA-beads, an effective cover, in this case, with an original double muscular flap and long-term antibiotics. The rapid normalization of the CRP (C Reactive Protein) is a good sign of healing and the authors think that MRI allows early detection of recurrence of infection and shows the good perfusion of the muscular flap.