The use of combined tactics for the treatment of pin osteomyelitis of the tibia: a case report

Introduction. Pin osteomyelitis is one of the most common complications of external transosseous osteosynthesis using the Ilizarov apparatus. The search for optimal treatment methods is still a topical issue of modern traumatology and orthopedics. The use of tactics for the treatment of pin osteomyelitis of the tibia using a two-stage method of treatment in combination with laser osteoperforation has not yet been carried out.Purpose of the study. To evaluate the effectiveness of the treatment of pin osteomyelitis of the tibia with cicatricial changes in soft tissues through the use of a two-stage treatment method in combination with laser osteoperforation.Case report. We present a clinical case of patient S., aged 56, diagnosed with pin osteomyelitis of the left tibia. At the first stage, the patient underwentsanitation of the focus of infection, minimally invasive laser osteoperfraction of the left tibia, and installation of a cement antibacterial spacer. A month after the operation, after stopping the infectious process, the patient underwent the second stage - removal of the spacer, minimally invasive laser osteoperforation of the left tibia, bone alloplasty with a biocomposite osteoconductive preparation. Follow-up was carried out in the postoperative period for 6 months. Treatment efficacy was assessed using a visual analogue scale (VAS) and laboratory parameters of ESR and C-reactive protein. As a result of the treatment, the infectious-inflammatory process was completely stopped, the pain syndrome was stopped, and remission was achieved.Conclusions. The combined tactics of treating osteomyelitis using a two-stage technique and laser osteoperforation at all stages showed its effectiveness due to adequate debridement and minimally invasive intervention. The result of this work showed that in the case of pronounced cicatricial changes of the lower leg in chronic osteomyelitis, it is necessary to choose more minimally invasive techniques, as this helps to reduce the risk of recurrence in the postoperative period.