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Recibido el 23 de Mayo de 2019. Aceptado el 02 de Julio de 2019
ESPÍN, G.; CONCHA, L.; ESPÍN, L. & SILVA, R. Treatment with osteoperiosteal decortization in humeral bone defect due to infection. Case report. J. health med. sci., 5(3):203-209, 2019.
ABSTRACT: Osteomyelitis (OM) is an infectious disease of difficult diagnoses and complex treatment due to its heterogeneity, physiopathology, clinical presentation and management. One of the complications in the OM management is the formation of infected pseudoarthrosis, which requires treatment methods that gives control over the infection, and stability over the infected segment to restore the osseous continuity. We presented the case of a six years old child who after an over infected insect bite on the superior left limb was transferred to our hospital emergency services. It was diagnosed with left humerus OM with a positive culture for Staphylococcus aureus and antibiotics with Oxacillin 4 g/day and Clindamycin 800 mg/day. Multiple surgical cleaning and sequestrum removal were made. The year post treatment he presented humerus pseudoarthrosis, so it was carried out the surgical technique of osteoperiosteal decortization and the insertion of autologous spongy bone tissue. The patient was tracked by three months, post-surgical complications were not reported and there was a favorable clinical evolution. At six and twelve post-surgical months he was reevaluated once again, which evidenced fibrocartilage callus formation. The infected humerus pseudoarthrosis treatment is a complex issue in which antibiotic therapies should be considered as the first management step regardless of surgical treatment. Osteoperiosteal decortization is a reliable technique that leads to predictable and satisfying results at the humerus nonunion, and the insertion of autologous tissue. Once the infectious procedure is controlled, is convenient the humerus pseudoarthrosis treatment.
KEY WORDS: osteomyelitis, pseudoarthrosis, humerus, osteoperiosteal decortization