EUROMEDICA  Hanover 1-2  Juni 2007	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

Home

Abstracts

Contact

Disclaimer

Nowadays classifications of osteomyelitis of long tubular bones can not be optimal, because of the fact, that some of them do not deal with all problems of purulent process and seemed to be cumbersome and not convenient in practice. Clearly the development of inflammatory process and convalescence of the patient with osteomyelitis of long tubular bones depend not only on the dynamics of the purulent process in the bone, but on the disorders in the surrounding tissues and vessels. As this fact based, doctors of the traumatology and orthopedy department and medicine of catastrophes department of Moscow State University of Medicine and Dentistry have worked out the classification of osteomyelitis of long tubular bones. The prototype of our classification was the classification of open non-battle long tubular bones fractures by A.V. Kaplan and O.N. Markova.

Our classification consists of four parts. Respectively the first part consists the data about clinical dynamics of osteomyelitis (acute, subacute, chronic). The second part deals with the type of osteomyelitis (posttraumanic, hematogenos, postoperative). In the third part we put all information about site of the process. It includes data about anatomical structure or it details the site and the bone’s name. The fourth part of the classification consists of the genegal features, that influence on the dynamics of osteomyelitis, such as the change of surrounding tissues, circulation’s disorders. In classification, that we have worked out, severity of the osteomyelitic process of the limb segment corresponds to combination of four latin figures (I, II, III, IV) and five capital letters of russian alphabet (А, Б, В, Г, Д). The latin figures mean the severity of the purulent and necroc process in the bone, the letters – the severity and the size of the impingement of surrounding tissues and circulation’s disorders.

For example, I means the little local impingement in the bone, which size is not more than 1,5 cm and 1/3 of diameter; the figure II means the disorder of the bone tissue with the size from 2 to 9 cm and not more than 1/2 diameter of the long tubular bone. The figure III defines the purulent process in the bone, which sites not more than 10 cm and not more than 1/2 of diameter. The figure IV obtains significant impingement in the extremity. In fact, it could be the gangrene.

Capital letters of russian alphabet deal with the impingement of surrounding tissues in the affected zone. For example, letter «A» means not significant changes in the surrounding tissues, «Б» – the availability of scars, 1-2 fistulas. The letter «В» deals with situation of the skin pigmenyayion and the wound, which size is from 2 to 10 cm and/or 3 fistulas; the letter «Г» - availability of big wound , which size is more than 10 cm, and plural fistulas; the letter «Д» defines lymphatic and veinosus insufficiency.

Our experience has proved the convenience and the need of using this classification in clinical work.