Results of chronic osteomyelitis of the femur treated with hyperbaric oxygen: a preliminary report.

BACKGROUND Although only a few studies have shown the effectiveness, hyperbaric oxygen (HBO) therapy has been used as an adjunct in the management of chronic osteomyelitis in many hospitals in Taiwan. This retrospective study investigated the clinical results of HBO therapy for chronic refractory osteomyelitis of the femur. METHODS From December 1999 through May 2002, 13 patients with chronic refractory osteomyelitis of the femur were treated with adjunctive HBO. The most common infecting microorganism was Staphylococcus aureus. All cases were classified as type III or IV osteomyelitis according to the Cierny-Mader classification. Adequate surgical debridement and parenteral antibiotic treatment were performed. The average number of operations before HBO therapy was 4.6 times. HBO therapy at 2.5 atmospheres absolute for 120 minutes was administered for 5 days per week in all patients for an average of 50 days. The average number of HBO treatments was 32.2 times. The average follow-up period was 22 months, ranging from 12 to 42 months. RESULTS Complete eradication of infection with no recurrence of infection was noted in 12 of the 13 patients. One patient failed to respond to the treatment. The success rate of the treatment regimen was 92%. There were no HBO therapy related complications. CONCLUSION Hyperbaric oxygen therapy is an effective and safe adjunctive therapy for the management of chronic refractory osteomyelitis of the femur provided that patients had received adequate surgical debridement and appropriate antibiotic treatment.