The Journal of Bone and Joint Surgery, Vol 66, Issue 2 181-193, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
The efficacy of free tissue transfer in the treatment of osteomyelitis
AJ Weiland, JR Moore and RK Daniel
We evaluated the efficacy of free tissue transfer in the treatment of
osteomyelitis in thirty-three patients who were followed for an average of
41.4 months (range, twenty-four to fifty-nine months). The bone lesions
were classified in two ways: first, according to whether there had been
drainage for less or more than six months and second, according to whether
the lesion was Type I, II, or III. The thirty-three patients underwent a
total of thirty-seven free tissue transfers, and thirty (79 per cent) of
the transfers survived. Major complications were encountered after 41 per
cent of the surgical procedures, consisting of failure of the free tissue
transfer in seven patients (21 per cent) and recurrent sepsis in six (20
per cent) at follow-up. Four of the seven patients in whom the free tissue
transfer failed underwent an amputation. Six of the patients with a failed
transfer and nine of the ten with recurrent sepsis had a Type-III lesion.
Previously published reports have suggested that free tissue transfer is an
extremely successful and reliable procedure for the treatment of
osteomyelitis. In our series limited success was achieved in patients with
a Type-I or II lesion, but six of the patients with a Type-III lesion had
recurrence of infection despite a successful transfer.
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