Treatment of posttraumatic patella osteomyelitis with MRSA infection and knee stiffness: a case report
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CASE REPORT
Treatment of posttraumatic patella osteomyelitis with MRSA infection and knee stiffness: a case report Haiyong Ren1, Kai Huang1, Peijian Tong2 and Yansheng Zhu1*
Abstract Background: Posttraumatic patella osteomyelitis is rare, and the treatment of osteomyelitis remains to be challenging. Control of the infection commonly costs a long time, and it is easily to cause knee stiffness. In addition, there is no unified protocol for the treatment of knee stiffness. Case presentation: We reported a case of posttraumatic patella osteomyelitis that successive infected with methicillin-resistant staphylococcus aureus (MRSA) after multiple surgeries. We successfully treated osteomyelitis by one-staged surgery, but the patient present knee stiffness after treatment. Thus Ilizarov external fixation system was further used to gradually adjust the mobility by exerting mechanical stress to the joint. After adjusting the frame under a scheduled plan, the patient successfully restored satisfactory knee function. Conclusions: Adequate debridement is the key to control infections of posttraumatic osteomyelitis. Control the infection of posttraumatic patella osteomyelitis by one-staged surgery is achievable and could shorten the knee immobilization period. When knee stiffness occurs, scheduled range of motion (ROM) adjustment using Ilizarov frame with hinges might be a safe and useful method to restore function. Keywords: Patella, Posttraumatic osteomyelitis, MRSA, Knee stiffness, Ilizarov frame, Gastrocnemius muscle flap Background Osteomyelitis remains to be a challenging disease to manage [1, 2]. Post-traumatic osteomyelitis is mostly resulted from open fractures or improper management during surgical treatment, while posttraumatic osteomyelitis of the patella is relatively rare [3]. Treatment of posttraumatic patella osteomyelitis may be complicated by conditions such as tissue defects, fracture nonunion, ruptured patellar ligament or quadriceps tendon, or deep knee joint infection [4, 5]. The treatment commonly costs a long time; it is generally hard to achieve early rehabilitation and is easily to cause knee stiffness. Here we report *Correspondence: [email protected] 1 Department of Orthopedics, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, Zhejiang, China Full list of author information is available at the end of the article
one case of posttraumatic patella osteomyelitis with MRSA infection. The patient also suffered knee stiffness after long time immobilization. We controlled the infection by one-staged surgery, and Ilizarov external fixation was used to successfully restore the knee function.
Case presentation A previously healthy 31 years old man was transferred to our hospital with history of closed fracture of the right patellar after fall injury 13 months ago. He was treated surgically with open reduction tension band wiring at a local hospital. The patient developed wound infection after surgery. The wound was debrided 3 times in the following half a year and he al
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