UNASSIGNED: To observe the effect of negative pressure closure drainage combined with open bone grafting or bone migration in the treatment of tibial traumatic osteomyelitis.
UNASSIGNED: Eighty-six (86) cases of tibial traumatic osteomyelitis admitted to Hospital of the Chinese people\'s Liberation Army from September 2017 to September 2018 were randomly divided into control group and observation group, forty-three (43) cases each. Debridement, open bone grafting or bone migration was given to the control group.The observation group was treated with negative pressure closed drainage on the basis of the control group. In addition, the serum components such as CRP, TNF-α, IL-6 of the control group and observation group were detected respectively after surgery.
UNASSIGNED: Observation group granulation cover wound, fracture healing time was shorter than the control group, fracture healing rate was better than the control group, the difference has statistical significance (P<0.05). By comparing serum CRP, TNF-α, IL-6 levels before and after treatment in the two groups, it was found that the observation group was lower than the control group (P<0.05, respectively). Serum CRP, TNF-α, IL-6 levels were significantly (P<0.05).
UNASSIGNED: The treatment of tibial traumatic osteomyelitis with negative pressure closure drainage combined with open bone grafting or bone displacement has a good effect on fracture healing and is worth popularizing.

Traumatic osteomyelitis with accompanying soft tissue defects presents a significant therapeutic challenge. This prospective, randomised controlled trial aims to evaluate the efficacy of antibiotic-impregnated bone cement, flap coverage and negative pressure sealed irrigation in the management of traumatic osteomyelitis complicated by soft tissue defects. A total of 46 patients with clinically diagnosed traumatic osteomyelitis and soft tissue defects were randomised into a control group (n = 23) and an observation group (n = 23). The control group underwent standard flap coverage and negative-pressure lavage, while the observation group received an additional treatment with antibiotic-loaded bone cement. Efficacy was measured based on clinical criteria, surgical metrics and morphometric assessment of bone and soft tissue defects. Statistical analyses were performed using SPSS version 27.0. The observation group, treated with an integrated approach of flap coverage, negative pressure wound therapy (NPWT) and antibiotic-impregnated bone cement, demonstrated significantly higher overall treatment efficacy (91.3%) compared to the control group, which received only flap coverage and NPWT (65.2%) (p < 0.01). This enhanced efficacy was evidenced through various outcomes: the observation group experienced reduced surgical times, shorter hospital stays, fewer dressing changes and accelerated wound healing, all statistically significant (p < 0.001). Additionally, a quantitative analysis at 6-month post-treatment revealed that the observation group showed more substantial reductions in both bone and soft tissue defect sizes compared to the control group (p < 0.001). The multi-modal treatment strategy, combining skin flap coverage, antibiotic bone cement and negative-pressure irrigation, showed marked efficacy in treating traumatic osteomyelitis and associated soft tissue defects. This approach accelerated postoperative recovery and lowered costs.

To compare the clinical outcomes of linezolid and vancomycin regimens combined with one-stage surgery in treating traumatic osteomyelitis of the limbs caused by methicillin-resistant Staphylococcus aureus (MRSA) infection. A retrospective study was performed to analyze patients with traumatic osteomyelitis of the limbs attributable to MRSA infection. All of these patients received one-stage surgery to debride their wounds, with subsequent implantation of a vancomycin-loaded calcium sulfate artificial bone. Patients received either intravenous linezolid (study group) or vancomycin (control group) during the perioperative period. The postoperative inflammatory markers, renal function, duration of drainage catheter placement, duration of antibiotic administration, length of hospital stay, adverse events, and recurrence of osteomyelitis in these two groups were compared. The study group had a shorter duration of antibiotic administration and length of hospital stay (p < 0.05). There was a significant difference in the incidences of adverse events between the two groups (5.88% and 17.65% in the study and control groups, respectively, p < 0.05). There was no recurrence in either group during the three-year follow-up period. As of year, five after the surgery, one patient in the control group had a recurrence of osteomyelitis. The linezolid regimen should be preferred to the vancomycin regimen in patients with traumatic osteomyelitis of the extremities caused by MRSA infection because the linezolid regimen showed fewer adverse events, shorter periods of antibiotic use, and shorter hospital stay. However, both treatment regimens achieved satisfactory outcomes and warranted further investigations.

Osteomyelitis is an ancient disease with varied pathophysiology. The several clinical syndromes associated with bone infection have specific clinical presentations and microbiology. Successful recognition and management of the disease requires a knowledge of these mechanisms and the organisms most common in each. Diagnosis is made by a combination of clinical examination, supportive blood testing, and appropriate radiography. With these elements in place, patient presentation can be placed in the framework of a staging system, which often helps to suggest the appropriate mix of antimicrobial and surgical therapies.