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Revista Portuguesa de Ortopedia e Traumatologia

Print version ISSN 1646-2122


NEVES, João et al. Método de Papineau Uma opção válida no tratamento da osteomielite e/ou pseudartrose infetada. Rev. Port. Ortop. Traum. [online]. 2014, vol.22, n.4, pp.431-438. ISSN 1646-2122.

Introduction: Infected pseudarthrosis remains a challenging problem to treat. Papineau grafting or open cancellous bone grafting was initially described 40 years ago for the management of chronic osteomyelitis, this technique remains helpful alone or in association with other methods - Ilizarov. Objective: A clinical case report of a tibial pseudarthrosis caused by infection that after radical debridement leads to a major bone defect that we successful applied the Papineau grafting. Simultaneously we provide a review of the current evidence. Clinical case: The authors report a case of a 38 years old woman who suffered a complex and open fracture of the right ankle, initially treated with external fixator and empirical antibiotic therapy. Unfortunately, developed a tibial osteomyelitis caused by Enterococcus cloacae. The Papineau’s technique was applied in order to clean the infection and the defect resulting from debridement was filled with autograft. Discussion and Results: Although minor modifications have been made to the original protocol, as described by Papineau, the main stages of the procedure have been largely preserved. The 3 stages of protocol include debridement of necrotic or infected tissue, open cancellous bone grafting and soft tissue coverage, with secondary intention healing. In this case of post-traumatic osteomyelitis and nonunion, the authors applied the technique of Papineau as a technique of salvation, which have eliminated the infection and achieved bone fusion. Conclusions: Papineau’s procedure is a safe and simple salvage procedure and remains an excellent option for treating difficult infected nonunion of the tibia in the selected indications.

Keywords : Papineau; osteomyelitis; Pseudarthrosis; Infection; open cancellous bone grafting.

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