A twenty-eight-year-old man sustained an open, comminuted tibial plateau fracture from a gunshot wound. Treatment included external fixation, serial debridements, and subsequent open reduction and internal fixation. Five months later, he developed chronic osteomyelitis of the proximal part of the tibia. Intraosseous debridement and irrigation with an arthroscope and arthroscopic tools was performed through existing bone screw holes. At the time of the final follow-up, he had resolution of pain and no recurrent infection.
This minimally invasive technique may be considered for the treatment of chronic osteomyelitis of long bones to prevent structural destabilization and minimize disability.
1Madigan Army Medical Center, 9040 Fitzsimmons Street, Tacoma, WA 98431. E-mail address for B.K. Bean: Betsey.email@example.com. E-mail address for J.A. Grassbaugh: Jason.firstname.lastname@example.org