1. Of 359 cases of chronic osteomyelitis following compound fracture, 33, or approximately 10 per cent., were unhealed after two years of hospital treatment.
2. Chronic osteomyelitis of spongy bone, i.e., of the epiphysis of long bones, carpal and tarsal bones, is more difficult to cure than osteomyelitis of compact bone of the shafts.
3. Extensive tarsal involvement, where healing has not occurred within six months, requires amputation. The same applies to epiphyseal osteomyelitis, where resection is impractical.
4. Of the long bones, osteomyelitis of the femur is the most difficult to cure. 45 per cent. of unhealed cases were involvements of this bone.
5. Of the operative measures, careful effacements and partial closure gave the best and quickest results. The end-results of extensive effacements were excellent.
6. The employment of chemicals at time of operation is of secondary importance. Careful, thorough surgery is of first importance.
7. Plastic operations facilitate healing and are indicated for adherent scars or soft part defects.
8. Refraction is frequent in chronic osteomyelitis. The femur and tibia are most frequently fractured. Union is the rule. Non-union occurred only twice in fourteen such fractures.
(C) 1922 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.