Aira Hospital

Osteomyelitis means infection of a bone. It can be acute or chronic.

Acute Osteomyelitis is caused by bacterial invasion of the bone usually by the blood stream from some distant focus, like a boil. If treated promptly with high doses of antibiotics it can be cured without surgery. Otherwise the bone has to be drilled so that the pus in the read marrow can escape in addition to the administration of antibiotics. 

Acute osteomyelitis of femur before surgery	Acute osteomyelitis of femur after surgery
Drilling for pus in acute osteomyelitis	Drilling for pus in acute osteomyelitis

 

Chronic osteomyelitis is the end result of neglecting an acute infection of the bone. When the read bone marrow gets infected, the pressure inside the bone raises. Since the walls of the bone are rigid, the pressure can raise to such a high level that damage to the blood vessels occurs. Without sufficient blood circulation a part of the bone will die, forming a “sequester”. The dead bone acts like a foreign body, keeping the infection alive. The remaining healthy bone reacts to this foreign body with formation of new bone, forming an envelope around the dead bone, an” involucrum”. When the involucrum is abounding and stable, the dead bone can be removed, but not before. As soon as it has been removed, the infection will subside, as well as the formation of new bone. This new bone does not have the same quality as the extra bone formed around a fracture. It will not grow and heal by itself without the stimulus from the dead bone, and it cannot heal a fracture. If the sequester is removed before the involucrum is stable the bone will collapse and never heal. An amputation can then be the only solution to the problem.

Very few patients come in time for adequate treatment of acute osteomyelitis. On the other hand we treat many patients with chronic infections. Since orthopedic surgical service outside Addis Abeba is almost zero, we have many patients referred to our hospital. The surgical procedure can be extremely difficult, bloody and time consuming, but as the majority of these patients have suffered many years with pain, swelling and recurrent purulent drainage, it is extremely satisfying and rewarding whenever it turns out to be successful.

Girl with chronic ostemyelitis	chronic ostemyelitis of tibia (lower leg)
Seqvester (dead bone) exposed	seqvester (dead bone) being removed
Seqvester (dead bone) removed	Bone cleared from infectious matters
Wound closure	X-ray before surgery. Large seqvester seen
Patient after surgery	Happy face after succesfull surgery

 

The orthopedic equipment available in our operating theatre is very simple, but most important of all is the dedication and determination of the surgeon.

This is our instrument set which is used for all kind of orthopedic surgeries, even major ones. Not so fancy, but it works well in the right hands