OSTEOMYELITIS


Introduction- Osteomyelitis is a severe infection of bone, bone marrow and surrounding soft tissue Staphylococcus aureus causes 70-80% of bone infection. Bone is normally resistant to infection. However, when microorganisms are introduced into bone can cause osteomyelitis.

Entry of microorganisms by-
Direct- direct bone contamination from bone surgery, open fracture ( e.g. RTA)
Indirect- extension of soft tissue infection ( eg vascular ulcer). Haematogenous( blood borne) spread from other sites of infection.

Factors Affecting Extent of Infection –
1. Virulence of infecting organism
2. Underlying disease
3. Immune status of the host
4. Type, location, and vascularity of bone

Unless, the infective process is treated promptly, a bone abscess forms. The resulting abscess cavity contains dead bone tissue( sequestrum), which do not easily liquefy and drain. New bone growth (involucrum) forms and surrounds the sequestrum.

Clinical Manifestations :-
Systemic- fever, night sweats, chills, restlessness, nausea $ malaise.
Local- constant bone pain, swelling, tenderness, warmth at the site of infection.

Diagnosis :-
1. History and Physical examination.
2. X- ray- irregular decalcification, bone necrosis are evident.
3. Biopsy, wound culture- to determine the microorganism.
4. Blood investigation- WBC, ESR, blood culture.

Management:-

  1. Splinting or cast Immobilization- this may be necessary to immobilize the affected bone and nearby joints in order to avoid further trauma and to help the area to heal adequately.
  2. Goal of rehabilitation for progressive osteomyelitis is to restoring normal ROM, flexibility, strength and endurance that means maintain function and enhance mobility.
  3. AROM initially helps maintain flexibility $ strength and relieves musculoskeletal pain. As therapy progresses, PROM exercises are preferable to avoid overexertion or possible damage to muscles.
  4. Aerobic exercises that increases cardiovascular fitness are recommended.

Ms. Harshita Mittal, BPT – III Year, Department of Physiotherapy, Career Point University, Kota

Leave a Reply

Your email address will not be published. Required fields are marked *