While completing a clinical rotation at an orthopedic hospital you meet Chaz Jac
ID: 239893 • Letter: W
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While completing a clinical rotation at an orthopedic hospital you meet Chaz Jackson, a 23-year old young man who had surgical repair of a proximal tibial fracture resulting from a fall on a snowboard. He presented at the outpatient clinic 1.5 weeks after release from the hospital with increasing leg pain, persistent drainage from poorly healing incision sites and recurrent fever. Visual inspection reveals warm, red skin and swelling extending inferiorly from the knee down the shin. The attending physician's assistant is concerned about possible osteomyelitis. What is osteomyelitis? Which form does Chaz most likely suffer from? Support your answer. Is his condition acute or chronic? Support your answer. A. Describe the steps that are taken in the clinical setting to prevent osteomyelitis in patients who undergo surgical repair following bone trauma. B. You gain employment at this same hospital after completing your clinical program and are surprised to run into Chaz who is still a patient at the hospital's clinic. He relates to you that he has continued to have problems stemming from that initial infection - he now suffers from chronic osteomyelitis. C. In reviewing his chart you note that radiographic studies reveal a cortical sequestrum, the hallmark of chronic osteomyelitis. Explain what this is and how it differs from an involucrum, being sure to define what the latter conditions is. Contrast how treatments for chronic osteomyelitis versus more acute forms of the condition differ. D. References:Explanation / Answer
Osteomyelitis is a serious infection of the bone characterized by redness , swelling and tenderness over the affected site .The infection can be due to sepsis carried by blood or due to bone exposure to infection during trauma or surgery.
He is likely suffering from acute post traumatic osteomyelitis. He had a fall and had a surgical repair which means he had a trauma for which it was surgically treated but thus repair paved way for micro organism to enter his affected bone.
His condition is acute as infection is less than 6 weeks.
b)The best way to prevent osteomyelitis in the clinical setting are:
1) Proper hand washing before handling the patient.
2) Provide clean and dry environment as humid and sweaty environment can increase bacterial growth.
3) Maintaining strict aseptic techniques while dressing the wound.
4) Providing a good protein and calcium rich diet.
5) Providing antibiotics on time.
6) Assessing regularly for any abnormalities in the wound .like pus, discharge, redness.
C)Cortical sequestration is the complication of osteomyelitis where the part of the bone gets necrosed and separates from the normal bone whereas invocrum is the growth of new bone around the sequestrum.
D)Acute osteomyelitis requires a course of antibiotics IV and oxygen therapy along with hospitalization but as chronic is more severe it requires draining of the pus, debridement of necrosis, grafting along with rehabilitation support is required.
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