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Journal of Bone and Joint Surgery, 1950;32:103-108.
© 1950 by The Journal of Bone and Joint Surgery, Inc

STREPTOMYCIN IN TUBERCULOUS BONE AND JOINT LESIONS WITH MIXED INFECTION AND SINUSES

DAVID M. BOSWORTH M.D.1, A. DELLA PIETRA M.D.1, and RICHARD F. FARRELL M.D.1

1 St. Luke's and Sea View Hospitals, and the House of St. Giles the Cripple, New York City

1. At the present time, streptomycin represents a tremendous advance in the treatment of patients with these lesions. Streptomycin undoubtedly will he improved upon and superseded by some other agent in the future, giving us better control of this disease and possibly enabling us to eradicate it.

2. In closed lesions streptomycin, in dosages of 90 grams in a period of ninety days, has failed to arrest the tuberculous process permanently.

3. Failure of treatment with streptomycin suggests strongly the presence of a sequestrum, a thick-walled abscess, or inadequate surgery.

4. Healing seems to be related to the duration of administration of streptomycin and not to the total dosage.

5. In patients having sinuses, streptomycin should be continued after healing for a period at least half as long as the healing period itself.

6. Surgical ankylosis, or resection of non-weight-bearing joints, is apparently as necessary now as it ever has been, but is much safer and more effective. Indeed, at times surgical attack is made possible only by the use of streptomycin.


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