Mode of presentation and end results of management of haematogenous osteomyelitis at the orthopaedic unit Kenyatta National Hospital over a five year period

Abstract

A retrospective study comprising of 101 patients seen between 1st January, 1976 and 31st December 1980 was carried out. The data was obtained from the Orthopaedic Unit, Kabete which deals with all the orthopaedic problems at the Kenyatta National Hospital and is also a referral Unit for all the orthopaedic conditions which cannot be dealt with in the peripheral hospitals. It was found that most of the patients presented late and hence subsequent complications of acute osteomyelitis going into its chronic stage cannot be prevented by energetic medical treatment. Therefore, most of the cases dealt with were either in subacute or chronic stage with all sorts of possible complications. The commonest organisms responsible for the disease was found to be staphylococcus aureus which was resistant to penicillin and ampicillin. However, septrin was found to be effective for both the staphylococci aureus and the Gram negative organisms which were isolated in some cases. It was therefore thought to be an appropriate drug for blanket cover before sensitivity results could be achieved. The management had no definite protocol and antibiotic administration due to shortage of drugs was poorly monitored.

Recommendations were therefore made to the department to establish a protocol involving an aggressive approach to the management of this disease and to standardise the management for future guidance of younger doctors.