Defects in long bones from severe neglected osteitis.

Osteitis has been transformed in recent times from a lethal or crippling disease to one in which restitution of bone to normal can be expected (Trueta and Morgan 1954). Yet if diagnosis and treatment are delayed the disease, despite antibiotics, may show all its former complications and may run the same unfavourable course as was described by earlier surgeons (Pyrah and Pain 1933). In Africa and other underdeveloped countries osteitis still presents in the classical manner (Bryson and Mandell 1964) and the problem of complete bone destruction, exceptionally rare elsewhere, is still encountered. Thus it is not surprising that of the twelve patients to be described with this complication eleven were seen in the course of one year spent in Kenya (1965-66).