Hand Osteomyelitis : a systematic review of the literature and recommendations for diagnosis and management
Dargan, Dallan Wyman, Matthew Bhoora, Mahir Ronan, Dominic Baker, Megan Partridge, David Caddick, Jennifer Giblin, Victoria
Dargan, Dallan
Wyman, Matthew
Bhoora, Mahir
Ronan, Dominic
Baker, Megan
Partridge, David
Caddick, Jennifer
Giblin, Victoria
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Affiliation
Sheffield Teaching Hospitals NHS Foundation Trust; The University of Sheffield; Sandwell and West Birmingham NHS Trust
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Publication date
2024-10-27
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Abstract
Hand osteomyelitis is a complex condition to diagnose and treat, with an opportunity to improve care through organization of existing evidence. The literature was systematically searched for series of hand osteomyelitis between 1990 and 2022 for evidence regarding diagnosis and treatment, to formulate recommendations. Twenty-one series reported at least 5 cases of hand osteomyelitis in adults, with a total of 666 cases. Surgical debridement is central to treatment and oral antibiotics are sufficient for individuals without diabetes, renal or vascular disease, after debridement and resolution of associated sepsis. A 4- to 6-week duration of antibiotic therapy according to organism sensitivities is recommended, or a 2-week course after amputation. Delayed presentation is common and if over 6 months is associated with high amputation rates. Hand osteomyelitis with renal failure is associated with systemic complications. Reconstruction options include antibiotic-eluting spacers, osteosynthesis or arthrodesis, vascularized bone or adipose, regional soft tissue coverage and silicone implant arthroplasty.Level of Evidence: IV.
Citation
Dargan D, Wyman M, Bhoora M, Ronan D, Baker M, Partridge D, Caddick J, Giblin V. Hand Osteomyelitis: A Systematic Review of the Literature and Recommendations for Diagnosis and Management. Hand (N Y). 2024 Oct 27:15589447241284408. doi: 10.1177/15589447241284408. Epub ahead of print.
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Article