ObjectiveTo review the progress of clinical diagnosis and treatment of chronic osteomyelitis in adults.MethodsThe literature related to chronic osteomyelitis in recent years was extensively reviewed, and the clinical diagnosis and treatment methods were summarized.ResultsClinical characteristics and laboratory examination can help to diagnose chronic osteomyelitis in adults. Pathogenic identification is the basis for choosing antibiotics. Diagnostic imaging is specific. The treatment includes systemic treatment and local treatment, and the local treatment is the key to radical cure.ConclusionThe diagnosis of chronic osteomyelitis in adults should be made as early as possible. According to the anatomical and physiological classification of the patients, the appropriate treatment plan should be made.
Objective To study the effect of local appl ication of different concentrations of nerve growth factor (NGF) on fracture heal ing, and to further search for the appropriate concentration gradient of NGF to promote fracture heal ing. Methods Seventy-five adult male Sprague Dawley rats, weighing (220.0 ± 2.5) g, were made the right tibia fracture model at 1 cm distal from the tibial tubercle and randomly divided into 5 groups (groups A, B, C, D, and E, n=15). Fractures were treated with 0.3 mL normal sal ine containing different concentration of NGF (0.006 48 × 10-2, 0.032 40 × 10-2, 0.162 00 ×10-2, and 0.810 00 × 10-2 μg/g) in groups A, B, C, and D, respectively, and the same amount of normal sal ine in group E. After2, 4, and 6 weeks, the specimens were harvested from 5 rats of each group to perform the biochemical test and histological observation. Before the rats were sacrificed, the arteriovenous blood was taken from the eye-ball to test the alkal ine phosphatase (ALP) activity. Results After 2, 4, and 6 weeks, the gross observation showed that the size and hardness of bone tissue and callus tissue growth gradually increased in groups A, B, C, and D, and group D was higher than groups A, B, C, and E. The X-ray films showed that the calcified area gradually increased in groups A, B, C, and D, and group D was higher than groups A, B, C, and E. The histological observation showed that the trabecular qual ity and maturity in group D were better than those in groups A, B, C, and E. Group D was significantly higher than groups A, B, C, and E (P lt; 0.05) in the gray values of callus tissue and the calcium content of callus tissue at 4 and 6 weeks, in the wet weight of callus tissue at 2 and 4 weeks, and in the ALP content of serum at 2 weeks. The trabecula surface index of osteoblast, the trabecular volume, and the trabecular width decreased as time in the order of groups A, B, C, and D, which were higher than those of group E; group D was the highest, showing significant differences when compared with the other groups (P lt; 0.05). Conclusion The local appl ication of NGF can promote fracture heal ing in rats. The high concentration gradient of NGF (0.810 00 × 10-2 μg/g) has an obvious promotion role on fracture heal ing.