International Journal of Physical Medicine & Rehabilitation
Open Access

Abstract

Deep-Seated Post-Traumatic Osteomyelitis Following Open Femur and Tibia Fractures: Case Report and Literature Review

Craig H. Lichtblau*, Stephen Quinnan, Jaroslaw Michal Deszczynski, Gabrielle Meli, Marta Walachowska, Michalina Prowotorow

Osteomyelitis, a difficult to treat inflammation of bone and marrow, poses substantial challenges due to biofilm formation, relative avascularity, hardware involvement, and high recurrence risk. Staphylococcus aureus remains the most common causative pathogen, though a wide range of bacteria, mycobacteria and fungi may be implicated. Diagnosis integrates clinical features, laboratory markers, imaging, and bone biopsy, the latter remaining the gold standard for pathogen identification. Management strategies typically combine prolonged antimicrobial therapy with surgical debridement and, when necessary, reconstructive techniques or amputation. Adjunctive measures such as local antibiotic delivery and hyperbaric oxygen therapy may support outcomes in refractory cases. We present a complex case of post-traumatic osteomyelitis in a 65 year old man with high-energy open fractures of the femur and tibia sustained in a motor vehicle accident. His prolonged course required multiple surgical interventions, vascular repair, hardware removal, antibiotic spacers and hyperbaric oxygen therapy, complicated by persistent infection, chronic pain, and neurocognitive deficits. This case underscores the multifactorial challenges of osteomyelitis management and highlights the need for coordinated multidisciplinary care to optimize outcomes.

Published Date: 2025-09-22; Received Date: 2025-08-21