Chronic osteomyelitis in Ilorin, Nigeria.

AIM To review cases of chronic osteomyelitis managed at a private health institution (Ela Memorial Medical Centre, Ilorin, Nigeria) between March 1995 and February 2005. PATIENTS AND METHODS; Case notes and X-rays of the patients who presented at EMMC with chronic osteomyelitis were reviewed retrospectively. Age, sex, sites of bone involvement and outcome of treatment were recorded. Local surgical debridement (including saucerisation, sequestrectomy and curettage) was the cornerstone of treatment. All patients received antibiotics for at least 6 weeks. RESULTS Of the 107 cases, 71 (66.4%) were males, with a male-to-female ratio of 2:1. The mean age was 21.9 years (range 1.5 - 80 years). Chronic osteomyelitis is most common in the first and second decades of life (55.2%) and mostly affects people < 50 years of age (93.5%). Haematogenous osteomyelitis was the most common cause of chronic osteomyelitis (81.3%). The most common bone site was the tibia (32.7%). Nearly all (103) were adjudged cured; only 3 patients suffered a recurrence. CONCLUSION Chronic osteomyelitis is common in Nigeria. Most cases occur in the first and second decades of life, with haematogenous osteomyelitis being the most common cause. A high index of suspicion of osteomyelitis in children with septicaemia, and the proper treatment of patients with open fractures, will help to reduce the occurrence of the disease.