THE TREATMENT OF TUBERCULOUS BONE DISEASE BY SURGICAL DRAINAGE COMBINED WITH STREPTOMYCIN

¹ PITTSBURGH, PENNSYLVANIA

1. Following adequate surgical drainage and streptomycin therapy, destruction from bone and joint tuberculosis has been found to cease, and roentgenograms showed evidence of recalcification and apparent regeneration of bone. There has been no tendency toward reactivation of the lesion, clinically or symptomatically.

2. In closed bone lesions, the use of streptomycin alone has failed to control the progress of the disease in most cases.

3. In the surgically produced sinuses, subsidance of drainage and closure in periods of time varying from three to sixteen weeks has invariably taken place.

4. Although the surgically treated lesions will heal clinically, new lesions in other parts of the body may develop and progress, despite administration of streptomycin.

5. While lesions adequately drained surgically are healing, pre-existing sinuses from other lesions may fail to close.

6. The tendency for bone regeneration to occur in children, with re-establishment of an apparently normal epiphyseal plate and no disturbance in the rate of growth, has been particularly evident and gratifying.

7. A good functional range of motion in peripheral joints has been retained in almost. all cases, with little or no residual pain.

8. In those few cases in which a surgical arthrodesis was performed, fusion tended to occur rapidly.

9. A good functional range of motion has been the usual end result, even when there was roentgenographic evidence of extensive destruction of the joint.

10. The factor of secondary infection has apparently been of no consequence in the arrest and healing of these lesions.

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