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.
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.
- 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.
- Goal of rehabilitation for progressive osteomyelitis is to restoring normal ROM, flexibility, strength and endurance that means maintain function and enhance mobility.
- 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.
- Aerobic exercises that increases cardiovascular fitness are recommended.
Ms. Harshita Mittal, BPT – III Year, Department of Physiotherapy, Career Point University, Kota