PEMICU 2

Petaka Minibus
Erri Pratama
405140008
3M Anatomi
(Sendi & Prinsip
Pergerakan)
 Klasifikasi Sendi
Berdasarkan pergerakan:
Synarthrosis
Tidak mungkin ada pergerakan antara tulang tulang yg
berhubungan.
Di antara tulang: jaringan ikat (sindesnosis).
Co/ tulang tengkorak, antara gigi dan rahang, antara radius dan
ulna.
Amphiarthrosis
Pergerakan terbatas.
Umumnya bagian tulang yang berada pada sisi
persendian dilapisi oleh tulang rawan hialin dan
struktur keseluruhan berada dalam kapsul.
Contoh: sendi vertebra, dan simfisis pubis.
Diarthrosis
Pergerakan luas.
Ada celah sendi, rawan sendi yang licin dan
membran sinovium serta kapsul sendi.
Umumnya dijumpai pada sendi-sendi ekstremitas
Berdasarkan strukturnya:

Sendi Fibrosa
Dihubungjkan oleh jaringan
fibrosa.
Terdapat 3 tipe sendi fibrosa;
Sutura = diantara tulang tulang
tengkorak
Sindesmosis = jarak antara tulang yg
bersendi lbh lebar dan jar ikat lebih
bnyk di banding sutura.
Gomphosis = jr ikat yg
menghubungkan adlah periodontium
 Sendi Kartilago/tulang rawan
Ruang antar sendi diisi oleh tulang rawan dan
disokong oleh ligamen. Hanya dapat sedikit
bergerak.
Dua tipe sendi kartilaginosa:
Sinkondrosis : seluruh persendian diliputi oleh rawan
hialin. Mis: Sendi sendi kostokondral
Simfisis :memiliki hubungan fibrokartilago antara
tulang dan selapis tipis rawan hialin yang
menyelimuti permukaan sendi. Mis: simfisis pubis
dan sendi sendi pada tulang punggung.
Sendi Sinovial/sinovial joint :
Dilengkapi oleh kartilago yang melicinkan
permukaan sendi, kapsul sendi (kantung
sendi), membran sinovial (bagian dalam
kapsul), cairan sinovial yang berfungsi sebagai
pelumas dan ligamen yang berfungsi
memperkuat kapsul sendi.
Cairan sinovial normalnya bening, tidak
 Joint Actions

Spinal Column
Tulang vertebra: Flexion, Extension, Lateral Flexion and
Rotation.
Joint Actions
Sendi bahu
Elevation, Depression, Adduction and Abduction.
Joint Actions
Sendi bahu
Flexion,
Extension,
Adduction,
Abduction and
Medial
Rotation.
Joint Actions
Sendi siku
Joint Actions
Pergelangan tangan
Joint Actions
Sendi pinggul
Joint Actions
Otot lutut

Pergelanga
n kaki
3M Fraktur
(Definisi,
Klasifikasi,
Etiologi, Tanda &
Gejala)
 INTRODUCTION
A fracture is a break in the structural continuity of bone.
It may be no more than a crack, a crumpling or a
splintering of the cortex; more often the break is
complete and the bone fragments are displaced. If the
overlying skin remains intact it is a closed (or simple)
fracture; if the skin or one of the body cavities is
breached it is an open (or compound) fracture, liable to
contamination and infection.

eys, System of Orthopaedics and Fractures, 9th Edition, Page: 687

 How Fractures Happen?
Fractures result from:
(1) injury;
(2) repetitive stress; or
(3) abnormal weakening of the bone (a pathological
fracture)

eys, System of Orthopaedics and Fractures, 9th Edition, Page: 687

 FRACTURES DUE TO INJURY

Most fractures are caused by sudden and excessive force, which may be direct or
indirect. With a direct force the bone breaks at the point of impact; the soft tissues
also are damaged. A direct blow usually splits the bone transversely or may bend
it over a fulcrum so as to create a break with a buttery fragment.

Twisting causes a spiral fracture;

Compression causes a short oblique fracture.
Bending results in fracture with a triangular buttery fragment;
Tension tends to break the bone transversely; in some situations it may simply avulse
a small fragment of bone at the points of ligament or tendon insertion.

ys, System of Orthopaedics and Fractures, 9th Edition, Page: 687-688

ys, System of Orthopaedics and Fractures, 9th Edition, Page: 687-688
 FATIGUE OR STRESS FRACTURES

These fractures occur in normal bone which is subject to repeated heavy

loading, typically in athletes, dancers or military personnel who have
gruelling exercise programmes. These high loads create minute deformations
that initiate the normal process of remodelling a combination of bone
resorption and new bone formation in accordance with Wolffs law. When
exposure to stress and deformation is repeated and prolonged,
resorption occurs faster than replacement and leaves the area liable to
fracture. A similar problem occurs in individuals who are on medication that
alters the normal balance of bone resorption and replacement; stress fractures
are increasingly seen in patients with chronic inammatory diseases who are
on treatment with steroids or methotrexate.

ys, System of Orthopaedics and Fractures, 9th Edition, Page: 687-688

 PATHOLOGICAL FRACTURES

Fractures may occur even with normal stresses if the bone has
been weakened by a change in its structure (e.g. in
osteoporosis, osteogenesis imperfecta or Pagets disease) or
through a lytic lesion (e.g. a bone cyst or a metastasis).

ys, System of Orthopaedics and Fractures, 9th Edition, Page: 687-688

 COMPLETE FRACTURES
The bone is split into two or more fragments.
INCOMPLETE FRACTURES
Here the bone is incompletely divided and the periosteum
remains in continuity

eys, System of Orthopaedics and Fractures, 9th Edition, Page: 688

eys, System of Orthopaedics and Fractures, 9th Edition, Page: 688
Fracture
Classification
HOW FRACTURES ARE DISPLACED
After a complete fracture the fragments usually become displaced,
partly by the force of the injury, partly by gravity and partly by the
pull of muscles attached to them. Displacement is usually
described in terms of translation, alignment, rotation and altered
length:
Translation (shift) The fragments may be shifted sideways,
backward or forward in relation to each other, such that the
fracture surfaces lose contact. The fracture will usually unite as
long as sufficient contact between surfaces is achieved; this may
occur even if reduction is imperfect, or indeed even if the fracture
ends are off-ended but the bone segments come to lie side by
side.
Angulation (tilt) The fragments may be tilted or angulated in
relation to each other. Malalignment, if uncorrected, may lead to
deformity of the limb.
Rotation (twist) One of the fragments may be twisted on its
 HOW FRACTURES HEAL
The process of fracture repair varies according to the type of
bone involved and the amount of movement at the fracture site.

HEALING BY CALLUS
This is the natural form of healing in tubular bones; in the absence of
rigid fixation, it proceeds in five stages:

1. Tissue destruction and haematoma formation

2. Inammation and cellular proliferation
3. Callus formation
4. Consolidation
5. Remodelling

eys, System of Orthopaedics and Fractures, 9th Edition, Page: 690

eys, System of Orthopaedics and Fractures, 9th Edition, Page: 691
UNION, CONSOLIDATION AND
NON-UNION
Repair of a fracture is a continuous process: any stages
into which it is divided are necessarily arbitrary. In this
book the terms union and consolidation are used, and
they are defined as follows:

Union Union is incomplete repair; the ensheathing

callus is calcified. Clinically the fracture site is still a little
tender and, though the bone moves in one piece (and in
that sense is united), attempted angulation is painful. X-
Rays show the fracture line still clearly visible, with uffy
callus around it. Repair is incomplete and it is not safe to
Consolidation Consolidation is complete repair; the calcified callus is
ossified. Clinically the fracture site is not tender, no movement can be
obtained and attempted angulation is painless. X-rays show the fracture
line to be almost obliterated and crossed by bone trabeculae, with well-
defined callus around it. Repair is complete and further protection is
unnecessary.
Non-union Sometimes the normal process of fracture repair is
thwarted and the bone fails to unite. Causes of non-union are:
(1)distraction and separation of the fragments, sometimes the result of
interposition of soft tissues between the fragments;
(2)excessive movement at the fracture line;
(3)a severe injury that renders the local tissues nonviable or nearly so;
(4)a poor local blood supply and
(5) infection
eys, System of Orthopaedics and Fractures, 9th Edition, Page: 691
eys, System of Orthopaedics and Fractures, 9th Edition, Page: 691
GENERAL SIGNS

Follow the ABCs: look for, and if necessary attend to,

Airway obstruction, Breathing problems, Circulatory
problems and Cervical spine injury.
 LOCAL SIGNS
Injured tissues must be handled gently. To elicit crepitus or abnormal
movement is unnecessarily painful; x-ray diagnosis is more reliable.
Nevertheless the familiar headings of clinical examination should
always be considered, or damage to arteries, nerves and ligaments
may be overlooked. A systematic approach is always helpful:
Examine the most obviously injured part.
Test for artery and nerve damage.
Look for associated injuries in the region.
Look for associated injuries in distant parts.

eys, System of Orthopaedics and Fractures, 9th Edition, Page: 692

 Look Feel
Swelling, bruising and deformity The injured part is gently palpated for
may be obvious, but the important localized tenderness. Some fractures
point is whether the skin is intact; would be missed if not specifically
if the skin is broken and the looked for, e.g. the classical sign
wound communicates with the (indeed the only clinical sign!) of a
fracture, the injury is open fractured scaphoid is tenderness on
(compound). Note also the pressure precisely in the anatomical
posture of the distal extremity and snuff-box. The common and
the colour of the skin (for tell-tale characteristic associated injuries
signs of nerve or vessel damage). should also be felt for, even if the
Move patient does not complain of them.
Crepitus and abnormal movement For example, an isolated fracture of
may be present, but why inict the proximal fibula should always
pain when x-rays are available? It alert to the likelihood of an associated
is more important to ask if the fracture or ligament injury of the
patient can move the joints distal ankle, and in high-energy injuries
eys,to the injury.
System always
of Orthopaedics and Fractures, 9th Edition, examine the spine and pelvis.
Page: 692
3M Dislokasi
(Definisi,
Klasifikasi,
Etiologi, Tanda &
Gejala)
Dislokasi
Permukaan sendi yang kehilangan kontak satu dengan
lainnya akibat kehilangan stabilitas struktur persendian.
Faktor resiko Jenis kelamin (Laki-laki), Usia muda,
Pekerjaan, Keturunan (Ligament yang lebih longgar)
Stabilitas Sendi
3 faktor yang membentuk struktur sendi :
Kontur permukaan sendi yang berhadapan
Integritas kapsul fibrosa dan ligamen
Kekuatan protektif otot yang menggerakan sendi

Kerusakan salah satu -> instabilitas sendi -> dislokasi

Klasifikasi Dislokasi
Dislokasi sebagian (subluksasi)
kehilangan kontak sebagian permukaan sendi
Dislokasi Komplit
Kehilangan kontak seluruh permukaan sendi
Fraktur Dislokasi
Dislokasi disertai fraktur disekitar sendi
 EPIDEMIOLOGI DISLOKASI
Dislokasi sendi bahu dan sendi pinggul
(paha) adalah dua jenis dislokasi yang
sering terjadi.
Epidemiologi Laki-laki > perempuan,
puncak pada umur 20-29 tahun
 ETIOLOGI DISLOKASI
Dislokasi kongenital : terjadi sejak lahir
akibat kesalahan pertumbuhan
Dislokasi patologik : akibat penyakit
sendi dan atau jaringan sekitar sendi,
misalnya tumor, infeksi, atau
osteoporosis tulang. Ini disebabkan oleh
kekuatan tulang yang berkurang
 PATOFISIOLOGI DISLOKASI
Dislokasi sendi bahu (gleno humeral joint)
Anterior: kaput humerus menembus kapsul
anterior sendi
Posterior: trauma langsung,jatuh,pundak
bagian belakakng terbentur lantai atau
tanah
Dislokasi inferior atau luksasi erekta: kaput
humerus mengalami jepitan di bawah
glenoid terjepit dalam kapsul yang robek
(button hole effect)
 PATOFISIOLOGI DISLOKASI
Dislokasi sendi siku:
Penderita jatuh dalam posisi siku eksi atau
hiperekstensi -> bagian distal humerus
terdorong ke depan merobek kapsul anterior
sedangkan radius dan ulna mengalami
dislokasi ke posterior
 PATOFISIOLOGI DISLOKASI
Dislokasi sendi acromio-clavicula
Dorongan yang kuat pada daerah
acromion ke bawah,sedangkan otot
trapezius dan otot sterneocleidomastoid
menarik dengan kuat clavicula keatas ->
kapsul dari sendi acromioclavicular robek
 PATOFISIOLOGI DISLOKASI
Dislokasi sendi Sternoklavikula
Terjadi benturan yang kuat di bagian
depan dari pundak -> dorongan ke
belakang yang kuat dari ujung lateral
klavikula dan mendorong bagian medial
klavikula ke depan ->kapsul sendi
sternoklavikula robek
TANDA DAN GEJALA DISLOKASI
Terjadi deformitas :
Tonjolan tulang yang normal menjadi tidak
terlihat. Contoh : dislokasi sendi bahu yang
menyebabkan deltoid menjadi rata
Pemendekan
Kedudukan yang khas. Contoh : dislokasi posterior
sendi panggul yang menyebabkan panggul
mengalami endorotasi, eksi, dan adduksi
Nyeri
Pergerakan pada sendi yang mengalami
dislokasi menjadi terbatas
 PEMERIKSAAN DISLOKASI
Anamnesis : terjadi trauma, mekanisme
trauma, ada rasa sendi keluar (bila
trauma minimal, kemungkinan terjadi
dislokasi rekuren)
Pemeriksaan klinis : adanya deformitas,
nyeri tekan, dan fungtio lesa
Pemeriksaan radiologi :membedakan
subluksasi,dislokasi atau fraktur.
Pemotretan minimal dengan 2 proyeksi :
anteroposterior (AP) dan lateral
Tatalaksana

Pertolongan pertama :
ABC (Airway, Breathing, Circulation)
CPR, bantuan pernafasan, dan menghentikan pendarahan
Mengecek dan mendokumentasikan keadaan neurovaskuler sekitar
Menutupi luka terbuka dengan kain steril
Kompres dengan es batu untuk mengurangi rasa sakit dan bengkak
Reposisi, Operasi, Analgesik, Immobilisasi, NSAIDs, Fisioterapi,
Gizi yang baik (Dihomo--linoleic acid,)
3M Pemeriksaan
Fisik & Penunjang
X-RAY X-ray examination is mandatory. Remember the rule of twos:
Two views A fracture or a dislocation may not be seen on a single x-
ray film, and at least two views (anteroposterior and lateral) must be
taken.
Two joints In the forearm or leg, one bone may be fractured and
angulated. Angulation, however, is impossible unless the other bone is
also broken, or a joint dislocated. The joints above and below the
fracture must both be included on the x-ray films.
Two limbs In children, the appearance of immature epiphyses may
confuse the diagnosis of a fracture; x-rays of the uninjured limb are
needed for comparison.
Two injuries Severe force often causes injuries at more than one
level. Thus, with fractures of the calcaneum or femur it is important to
also x-ray the pelvis and spine.
Two occasions Some fractures are notoriously difficult to detect soon
after injury, but another x-ray examination a week or two later may
show the lesion. Common examples are undisplaced fractures of the
SPECIAL IMAGING
Sometimes the fracture or the full extent of the fracture is
not apparent on the plain x-ray. Computed tomography may be
helpful in lesions of the spine or for complex joint fractures;
indeed, these crosssectional images are essential for accurate
visualization of fractures in difficult sites such as the
calcaneum or acetabulum. Magnetic resonance imaging may
be the only way of showing whether a fractured vertebra is
threatening to compress the spinal cord. Radioisotope scanning
is helpful in diagnosing a suspected stress fracture or other
undisplaced fractures.
3M Tatalaksana
Farmakologis &
Non-Farmakologis
TREATMENT OF CLOSED FRACTURES

Treatment of the fracture consists of manipulation to

improve the position of the fragments, followed by
splintage to hold them together until they unite;
meanwhile joint movement and function must be
preserved. Fracture healing is promoted by
physiological loading of the bone, so muscle activity
and early weightbearing are encouraged. These
objectives are covered by three simple injunctions:
Reduce.
Hold.
Exercise.
Tscherne (Oestern and Tscherne, 1984) has devised a helpful
classification of closed injuries:
Grade 0 a simple fracture with little or no softtissue injury.
Grade 1 a fracture with superficial abrasion or bruising of the
skin and subcutaneous tissue.
Grade 2 a more severe fracture with deep softtissue contusion
and swelling.
Grade 3 a severe injury with marked soft-tissue damage and a
threatened compartment syndrome
there are some situations in which reduction is
unnecessary:
(1) when there is little or no displacement;
(2) when displacement does not matter initially (e.g. in
fractures of the clavicle) and
(3) when reduction is unlikely to succeed (e.g. with
compression fractures of the vertebrae). Reduction should
aim for adequate apposition and normal alignment of the
bone fragments
CLOSED REDUCTION
Under appropriate anaesthesia and muscle relaxation, the
fracture is reduced by a three-fold manoeuvre:
(1)the distal part of the limb is pulled in the line of the
bone;
(2)as the fragments disengage, they are repositioned (by
reversing the original direction of force if this can be
deduced) and
(3)alignment is adjusted in each plane
In general, closed reduction is used for all
minimally displaced fractures, for most fractures
in children and for fractures that are not
unstable after reduction and can be held in some
form of splint or cast. Unstable fractures can also
be reduced using closed methods prior to
stabilization with internal or external fixation.
OPEN REDUCTION
Operative reduction of the fracture under direct vision is
indicated:
(1)when closed reduction fails, either because of difficulty
in controlling the fragments or because soft tissues are
interposed between them;
(2)when there is a large articular fragment that needs
accurate positioning or
(3)for traction (avulsion) fractures in which the fragments
are held apart. As a rule, however, open reduction is
merely the first step to internal fixation.
INTERNAL FIXATION
Indications Internal fixation is often the most desirable form of
treatment. The chief indications are:
1. Fractures that cannot be reduced except by operation.
2. Fractures that are inherently unstable and prone to re-displace
after reduction (e.g. mid-shaft fractures of the forearm and some
displaced ankle
fractures). Also included are those fractures liable to be pulled apart
by muscle action (e.g. transverse fracture of the patella or
olecranon).
3. Fractures that unite poorly and slowly, principally fractures of the
femoral neck.
4. Pathological fractures in which bone disease may prevent healing.
5. Multiple fractures where early fixation (by either internal or
external fixation) reduces the risk of general complications and late
multisystem organ failure (Pape et al., 2005; Roberts et al., 2005).
Complications of internal fixation
Most of the complications of internal fixation are due to poor technique, poor
equipment or poor operating conditions:
Infection Iatrogenic infection is now the most common cause of chronic
osteomyelitis; the metal does not predispose to infection but the operation and
quality of the patients tissues do.
Non-union If the bones have been fixed rigidly with a gap between the ends,
the fracture may fail to unite. This is more likely in the leg or the forearm if one
bone is fractured and the other remains intact. Other causes of non-union are
stripping of the soft tissues and damage to the blood supply in the course of
operative fixation.
Implant failure Metal is subject to fatigue and can fail unless some union of
the fracture has occurred. Stress must therefore be avoided and a patient with a
broken tibia internally fixed should walk with crutches and stay
away from partial weightbearing for 6 weeks or longer, until callus or other
radiological sign of fracture healing is seen on x-ray. Pain at the fracture site is a
danger signal and must be investigated.
Refracture It is important not to remove metal implants too soon, or the bone
EXTERNAL FIXATION
A fracture may be held by transfixing screws or
tensioned wires that pass through the bone above
and below the fracture and are attached to an
external frame. This is especially applicable to the
tibia and pelvis, but the method is also used for
fractures of the femur, humerus, lower radius and
even bones of the hand.
Indications External fixation is particularly useful for:
1. Fractures associated with severe soft-tissue damage
(including open fractures) or those that are contaminated,
where internal fixation is risky and repeated access is
needed for wound inspection, dressing or plastic surgery.
2. Fractures around joints that are potentially suitable for
internal fixation but the soft tissues are too swollen to allow
safe surgery; here, a spanning external fixator provides
stability until soft-tissue conditions improve.
3. Patients with severe multiple injuries, especially if there are
bilateral femoral fractures, pelvic fractures with severe
bleeding, and those with limb and associated chest or head
injuries.
Complications
Damage to soft-tissue structures
Transfixing pins or wires may injure nerves or vessels, or may tether
ligaments and inhibit joint movement. The surgeon must be
thoroughly familiar with the cross-sectional anatomy before
operating.
Overdistraction
If there is no contact between the fragments, union is unlikely.
Pin-track infection
This is less likely with good operative technique. Nevertheless,
meticulous pin-site care is essential, and antibiotics should be
administered immediately if infection occurs.
3M Infeksi
(Kelainan Tulang
& Trauma)
Septic arthritis is also known as infectious
arthritis, and is usually caused by bacteria, or
fungus. The condition is an inammation of a
joint that's caused by infection. Typically, septic
arthritis affects one large joint in the body, such
as the knee or hip. Less frequently, septic
arthritis can affect multiple joints.
 What Causes Septic Arthritis?

Septic arthritis usually is caused by bacteria that

spread through the blood stream from another area of
the body. It can also be caused by a bacterial infection
from an open wound or an opening from a surgical
procedure, such as knee surgery. In adults and
children, common bacteria that cause acute septic
arthritis include Haemophilus inuenza,
staphylococcus, and streptococcus. These foreign
invaders enter the bloodstream and infect the joint,
causing inammation and pain
http://www.webmd.com/arthritis/septic-arthritis-symptoms-diagnosis-and-
 Other infections, such as those caused by viruses and fungi, can
also cause arthritis. Viruses include:
Hepatitis A, B, and C
Parvovirus B19
Herpes viruses
HIV (AIDS virus)
HTLV-1
Adenovirus
Coxsackie viruses
Mumps

Fungi that can cause arthritis include histoplasma,

coccidiomyces, and blastomyces. These infections are usually
lslower to develop than bacterial infections.
http://www.webmd.com/arthritis/septic-arthritis-symptoms-diagnosis-and-
 Who's at Risk for Septic Arthritis?
Young children and elderly adults are most likely to
develop septic arthritis. People with open wounds are
also at a higher risk for septic arthritis. In addition,
people with a weakened immune system and those
with pre-existing conditions such as cancer,
diabetes, intravenous drug abuse, and immune
deficiency disorders have a higher risk of septic
arthritis. In addition, previously damaged joints have
an increased likelihood of becoming infected.
http://www.webmd.com/arthritis/septic-arthritis-symptoms-diagnosis-and-
 What Are the Symptoms of Septic
Arthritis?
Symptoms of septic arthritis usually come on rapidly with
intense pain, joint swelling, and fever. Septic arthritis
symptoms may include:

Chills
Fatigue and generalized weakness
Fever
Inability to move the limb with the infected joint
Severe pain in the affected joint, especially with
movement
Swelling (increased uid within the joint)
http://www.webmd.com/arthritis/septic-arthritis-symptoms-diagnosis-and-
 How Is Septic Arthritis
Diagnosed?
A procedure called
arthrocentesis is commonly
used to make an accurate
diagnosis of septic arthritis.
This procedure involves a
surgical puncture of the joint
to draw a sample of the joint
uid, known as synovial uid.
Normally, this uid is sterile
and acts as a lubricant.

http://www.webmd.com/arthritis/septic-arthritis-symptoms-diagnosis-and-
treatment
https://qph.is.quoracdn.net/main-qimg-32e228e844d8112ad449dda917b1236a?
During arthrocentesis, a needle is inserted into the affected
joint to collect uid from the joint. The uid sample is sent
to a lab for evaluation. The lab will perform a white cell
count on the uid, which will usually very high. The lab will
also try to culture bacteria or other organisms. This will help
the doctor determine if an infection is present and which
organism is causing it.

X-rays are typically done to look for joint damage. Blood

tests can also be used to monitor inammation. MRI
scanning is sensitive in evaluating joint destruction but is
less useful in the early stages . Blood tests can also be
taken to detect and monitor inammation.
What's the Treatment for Septic Arthritis?
Septic arthritis treatments include using a combination of powerful antibiotics as
well as draining the infected synovial fluid from the joint. It's likely that
antibiotics will be administered immediately to avoid the spread of the infection.
Intravenous (IV) antibiotics are given, usually requiring admission to the hospital
for initial treatment. The treatment, however, may be continued on an
outpatient basis at home with the assistance of a home health nursing service.

Initially, empiric antibiotics are chosen to cover a wide range of infections. If the
bacteria can be identified, antibiotics specific to that organism are used. It may
take four to six weeks of treatment with antibiotics to ensure complete
eradication of the infectious agents.
OSTEOMYELITIS

Osteomyelitis is an infection of the bone, a rare but

serious condition. Bones can become infected in a
number of ways: Infection in one part of the body may
spread through the bloodstream into the bone, or an
open fracture or surgery may expose the bone to
infection.
What Causes Osteomyelitis?
In most cases, a bacteria called Staphylococcus aureus,
a type of staph bacteria, causes osteomyelitis.

Certain chronic conditions like diabetes may increase

your risk for osteomyelitis.
Who Gets Osteomyelitis?
Only 2 out of every 10,000 people get osteomyelitis. The condition affects children
and adults, although in different ways. Certain conditions and behaviors that
weaken the immune system increase a person's risk for osteomyelitis, including:

Diabetes (most cases of osteomyelitis stem from diabetes)

Sickle cell disease
HIV or AIDS
Rheumatoid arthritis
Intravenous drug use
Alcoholism
Long-term use of steroids
Hemodialysis
Poor blood supply
Recent injury
Bone surgery, including hip and knee replacements, also increase the chance of
bone infection.
Osteomyelitis in Children and Adults
In children, osteomyelitis is usually acute. Acute osteomyelitis comes
on quickly, is easier to treat, and overall turns out better than chronic
osteomyelitis. In children, osteomyelitis usually shows up in arm or leg
bones.

In adults, osteomyelitis can be either acute or chronic. People with

diabetes, HIV, or peripheral vascular disease are more prone to chronic
osteomyelitis, which persists or recurs, despite treatment. Whether
chronic or acute, osteomyelitis often affects an adult's pelvis or
vertebrae of the spine. It can also occur in the feet, especially in a
person with diabetes.
Symptoms of Osteomyelitis
Acute osteomyelitis develops rapidly over a period of seven to 10
days. The symptoms for acute and chronic osteomyelitis are very
similar and include:

Fever, irritability, fatigue

Nausea
Tenderness, redness, and warmth in the area of the infection
Swelling around the affected bone
Lost range of motion
Osteomyelitis in the vertebrae makes itself known through severe
back pain, especially at night.
Osteomyelitis Treatment
Figuring out if a person has osteomyelitis is the first step in treatment. It's
also surprisingly difficult. Doctors rely on X-rays, blood tests, MRI, and
bone scans to get a picture of what's going on. A bone biopsy is necessary
to confirm a diagnosis of osteomyelitis. This also helps determine the type
of organism, typically bacteria, causing the infection so the right
medication can be prescribed. Treatment focuses on stopping infection in
its tracks and preserving as much function as possible. Most people with
osteomyelitis are treated with antibiotics, surgery, or both.
Antibiotics help bring the infection under control and often make it
possible to avoid surgery. People with osteomyelitis usually get antibiotics
for several weeks through an IV, and then switch to a pill form.
More serious or chronic osteomyelitis requires surgery to remove the
infected tissue and bone. Osteomyelitis surgery prevents the infection
from spreading further or getting so bad that amputation is the only
remaining option.
Preventing Osteomyelitis
The best way to prevent osteomyelitis is to keep things clean. If you or your child
has a cut, especially a deep cut, wash it completely. Flush out any open wound
under running water for five minutes, then bandage it in sterile bandages.
If you have chronic osteomyelitis, make sure your doctor knows about your medical
history so you can work together to keep the condition under control. If you have
diabetes, pay close attention to your feet and contact your doctor at the first sign of
infection.
The sooner you treat osteomyelitis, the better. In cases of acute osteomyelitis, early
treatment prevents the condition from becoming a chronic problem that requires
ongoing treatment. Besides the pain and inconvenience of repeated infections,
getting osteomyelitis under control early provides the best chance for recovery.