Tuesday, May 7, 2013

Osteomyelitis of the Foot

Osteomyelitis is a type of bacterial bone infection that moves from acute to chronic phases quickly. The
infection usually begins in another part of the body and spreads to the bone via blood. Traumatic injury, frequent medication injections, diabetic ulcers on the foot, the use of a prosthetic device, and some surgical procedures can increase susceptibility to the underlying infection.
With osteomyelitis, the infected bone fill with a pus that deprives the bone of its needed blood supply. Over time, this can result in the death of bone tissue. It is caused by staphylococcus bacteria, a germ that can be found on healthy people. This bacteria can enter your bloodstream through pneumonia or a urinary tract infection and to the weakened bone. Staphylococcus bacteria can also be transmitted through other infections or wounds in your body and direct contamination via a compound fracture.
Those with osteomyelitis may find that they are experiencing chills and fever, pain in the area of the infection, and swelling, warmth, and redness over the affected area. Sometimes osteomyelitis has no signs or symptoms or has signs or symptoms that can easily be diagnosed as something else.
If you've recently had a compound bone fracture, deep puncture wound, or surgery to repair broken bones, you are at risk for osteomyelitis. Those with poorly controlled diabetes, peripheral arterial disease, and sickle cell disease impair good blood flow, and therefore your body has a difficult time fighting infections like osteomyelitis. Individuals who use medical tubing for dialysis machines, urinary catheters, or for long-term intravenuous tubing have an "open gateway" for germs to enter. Conditions and factors that impair the immune system, like chemotherapy, having an organ transplant, or needing to take corticosteroids also put you at risk. Finally, those who take illegal drugs through needles are at risk because the needles are not typically sterilized before use.
Complications from osteomyelitis may include:
  • Bone death. Infection in the bone will impede blood circulation to the bone, and cause bone death. Your bone can, however, heal after surgery to remove small sections of dead bone. But, if a large part of your bone has died, amputation may be necessary. 
  • Septic arthritis. Infection in bones can spread to nearby joints. 
  • Impaired growth. In children with osteomyelitis, the growth plates are commonly affected. Normal growth can be affected in these areas.
  • Skin cancer. In cases where osteomyelitis has turned pussy, the surrounding skin can develop squamous skin cancer. 
The presence of bone infection can be diagnosed with tests, such as bone scans, blood tests, X-rays, CT scans, MRIs, and bone biopsies.
Osteomyelitis infections are very difficult to cure with oral or intravenuous antibiotics. In chronic cases, surgical removal of the dead bone tissue is usually required. Antibiotics are typically given through a vein in your arm for four to six weeks. Side effects include nausea, vomiting and diarrhea. Surgery may include one of the following methods:
  • Drain the infected area. By opening the area around the infection, your podiatric surgeon can drain any pus or fluid that has accumulated.
  • Remove the diseased bone and tissue. The surgeon will debride, or remove, as much of the diseased bone and tissue as possible, taking a small portion of healthy bone to ensure the infection is gone.
  • Restore the blood flow. Your surgeon may fill in the empty space from the debridement with a piece of bone or tissue as a temporary filler until you are healthy enough to get a bone or tissue graft. 
  • Remove foreign objects. If you've had this procedure previously, old plates or screws may have to be removed. 
  • Amputate the limb. This is a final recourse and will not happen in all cases. 
If you believe have a foot problem and do not currently see a podiatrist, call one of our six locations to make an appointment.
Connecticut Foot Care Centers
Podiatrists in CT
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