Abstract:

Objective To explore the efficacy of debridement combined with antibiotic-loaded artificial bone in the treatment of clavicular osteomyelitis. Methods The data of 45 patients with clavicle osteomyelitis admitted to Luoyang Orthopedic Hospital （Henan Orthopedic Hospital） in Henan Province from January 2012 to June 2022 were retrospectively analyzed. They were divided into treatment group （n = 24） treated with debridement combined with antibiotic-loaded artificial bone， and control group （n = 21） treated with debridement. We compared the operation time， the duration of drainage tube placement， wound healing time， white blood cells （WBC）， C-reactive protein （CRP）， and erythrocyte sedimentation rate （ESR） in the two groups. Preoperative visual analog scores （VAS） and VAS 1 month after operation， and preoperative Constant-Murley score （CMS） and CMS 12 months after operation were observed. Infections， recurrence and complications in the two groups were recorded in the follow-up. Results All the 45 patients completed the surgery successfully and were followed up for 13 to 35 months， with an average of （23.53 ± 5.11） months. The operation time and the duration of drainage tube placement of the treatment group were longer than those of the control group （P < 0.05）， and there was no significant difference in the wound healing time （P > 0.05）； preoperative and 14-day postoperative WBC， CRP， and ESR， VAS 1 month after operation， and CMS 12 months after operation were all significantly improved in the two groups. The differences were all statistically significant （P < 0.05）， and the CMS of the treatment group was higher than that of the control group （P < 0.05）. During the follow-up， there were less cases of infection recurrence in the treatment group when compared with that in the control group （2/24， 8.33% vs. 5/21， 23.81%）. There were 2 cases of aseptic exudation in the treatment group. There were 1 case of bone defect in the treatment group and 5 in the control group， all of which had healed after the second-stage iliac implantation， and the rest did not have the complication of aseptic exudation， bone defects and pathologic fracture. Conclusion Debridement and antibiotic-loaded artificial bone can effectively control the infection and preserve the shape and function of the clavicle， with a low recurrence rate of postoperative infection， simple surgical operation， and no serious complications. It is worthy of clinical promotion.

Key words: clavicle, osteomyelitis, debridement, antibiotic-loaded artificial bone