1173 What Influences Taylor Spatial Frame Effectiveness in the Treatment of Tibial Osteomyelitis? A Major Trauma Centre Perspective

Aim

Treatment of tibial osteomyelitis can be challenging, with numerous complications possible during rehabilitation. We report on the usage of the Taylor Spatial Frame (TSF) and analyse factors that affect outcomes.

Method

Between 2015-2020, 51 patients were treated with TSF for osteomyelitis at a Major Trauma Centre. Demographic, infection, and treatment factors were collected, with microbiology results, antibiotic treatment regimes, and time to partial weight-bear (PWB) and full weight-bear (FWB) prescriptions also noted. Outcomes of complications and time to union were obtained.

Results

Radiological union was achieved at mean 11.0 months. Mean follow up was 24.1 months. Six/three patients were further treated with fusion/amputation respectively. Mean treatment time with TSF was 12.1 months. 78% had some complications, with pin-site infection, malunion, and non-union being most prevalent.

Staphylococcus epidermidis in bone debridement microbiology was significantly negatively associated with pin-site infection (OR = 0.093, 95% CI [0.011-0.828] ) and malunion (OR = 0.698 95% CI[0.573-0.849]), and enterococcus with non-union (OR = 0.775, 95% CI [0.656-0.916] ), during the treatment period. Time to union was significantly positively associated with time from admission to debridement (p = 0.035), time TSF was in (p = 0.021), presence of any complications (p = 0.045), bone loss complication (p = 0.037), time to FWB prescription (p = 0.001).

Conclusions

We have analysed the effectiveness of TSF in the treatment of tibial osteomyelitis, and elucidated the most important injury, treatment and rehabilitation factors that affect outcome. The negative bacterial-complication cross associations could be due to successful eradication as culture specific antibiotics were used postoperatively. Earlier patient full weight bearing could enhance callous formation leading to faster union.