Osteitis and Septic Arthritis after Tibial Head Fracture: Results of a Radical Treatment Regime.

OBJECTIVES

We report a series of 37 consecutive patients with both bone infection and septic arthritis of the knee following fracture of the proximal tibia. Aim of this study is to evaluate treatment results using a standardized treatment regime. The treatment regime consisted of an aggressive surgical approach to both the bone and the joint. In 61% the joint function was preserved, in the reminder an arthrodesis was required, there were no amputations. The difficulties in dealing with this condition are described as well as the clinical, radiological and occupational results.

DESIGN/

SETTING

Data collection was prospective. Data gathered at follow up included clinical examination, radiographs and the Rassmussen scoring system. Setting is a bone and joint infection and reconstruction unit of a tertiary referral hospital.

PATIENTS/

METHODS

Nine patients were female (24.3%). Mean age was 47.7 years (16.6-76.7 years). We classified fracture types according to Schatzker; ofwhich type VI fractures were the largest group with 13 cases.

RESULTS

About 3.2 operations where required on average (1-7) for the treatment of infection. For 22 patients the joint function was salvaged. In the remaining cases an arthrodesis was required.

CONCLUSIONS

The reported treatment regime gives reliable results for the treatment of combined bone and joint infection of the knee after fracture. In a large group of cases it was possible to salvage joint function. Comparison to other forms of treatment is not possible as there are no reported results so far.